Diagnostic Imaging of Pregnant Women – The Role of Magnetic Resonance Imaging

Abstract

SummaryBackgroundPresentation of magnetic resonance imaging (MRI) findings in pregnant women in the Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.Material/MethodsForty-three symptomatic pregnant women underwent MRI between 9 and 33 weeks of gestation (mean of 23 weeks). Moreover, we included 2 pregnant women who underwent fetal MRI and had incidental abnormalities.ResultsIn 9 cases, we excluded the suspected brain abnormalities. In 4 cases, we found unremarkable changes in the brain without clinical significance. One patient was diagnosed with multiple sclerosis, one with cortical dysplasia, one with pineal hemorrhage and one with a brain tumor. On abdominal MRI, 2 patients had normal findings, one patient had colon cancer with a hepatic metastasis, one patient had a hepatic angioma, one patient had an extraadrenal pheochromocytoma, one patient had an abscess in the iliopsoas muscle, 9 patients had myomas, two patients had ovarian simple cysts, two endometrial cysts, three dermoid cysts, one patient had sacrococcygeal teratoma, one patient had a cystadenofibroma (partial borderline tumor), one patient had an androgenic ovarian tumor and two patients had hyperreactio luteinalis. One patient was diagnosed with transient osteoporosis of the hip and one with a stress fracture of the sacral bone.ConclusionsMagnetic resonance imaging is the best imaging modality for pregnant women. Although ultrasonography is the method of choice, doubtful cases as well as structures that cannot be examined with ultrasonography can be non-invasively evaluated with MRI.

Management of hypertension in pregnancy — prevention, diagnosis, treatment and long-term prognosis. A position statement of the Polish Society of Hypertension, Polish Cardiac Society and Polish Society of Gynaecologists and Obstetricians

“…Modern MRI devices enable not only accurate and reliable assessment of renal artery stenosis, but also facilitate diagnosis of many other pathologies (e.g. pheochromocytoma) even with non-contrast-enhanced scans [34,35].…”

A Rare Case of Advanced-Stage Small Cell Carcinoma of the Ovary Identified During the Third Trimester of Pregnancy

“…CT, being more accessible, is more frequently utilized compared to MRI. However, in pregnant patients, MRI is preferred due to its avoidance of high-contrast resolution and radiation exposure to the fetus in comparison to CT [ 11 ]. In the presented case, the patient did not have hypercalcemia on her pathology tests; however, notable findings included elevated CA 125 levels and the presence of a prominent likely ovarian mass with ascites appreciated on both ultrasound and MRI.…”

Primary ovarian small cell carcinoma of hypercalcemic type in a pregnant woman

“…But use of the MRI contrast agent gadolinium is discouraged as it crosses the placenta and is excreted into the amniotic fluid. [ 20 ] A study by Bekiesińska-Figatowska et al [ 21 ] of about 43 symptomatic pregnant women between 9 and 33 weeks’ gestation who required an imaging work-up suggested that MRI is the best imaging modality for pregnant women when US is inconclusive, when masses are too large to fully assess with US, or when there is a high risk of malignancy. Pregnancy affects growth invasion and metastasis in ovarian cancer, and ovarian cancer increases various maternal and fetal complications.…”