Gabriele Masselli MD, Presenter: Nothing to Disclose

Emanuele Casciani, Abstract Co-Author: Nothing to Disclose

Elisabetta Polettini MD, Abstract Co-Author: Nothing to Disclose

Luca Bertini MD, Abstract Co-Author: Nothing to Disclose

Gian Franco Gualdi MD, Abstract Co-Author: Nothing to Disclose

The diagnosis of pelvic conditions during pregnancy can be challenging. Aim was to assess the per-formance of MR imaging in the evaluation and triage of pregnant patients presenting with acute pelvic pain.

89 pregnant patients who underwent to MR examination because of acute pelvic pain were included in this prospective study. A US examination was performed in all patients before MR. Multiplanar HASTE, TRUE FISP and GRE MR images were obtained on 1.5 T Siemens Avanto Scanner. In 71/89 (79%) of studies, gadolinium was not administered. The prospective clinical MR interpretations were compared with follow-up and surgical records to determine the correctness of the interpretation.   

MR examinations demonstrated abnormalities in 34 patients: adnexal lesions (n = 3), ovarian torsion (n=1), urinary pathology (n = 5), degenerating fibroid (n = 3), placenta abruption (n=7), DVT (n = 2), hernia (n = 1), colitis (n = 1), thick terminal ileum (n = 1), rectus hematoma (n = 1), appendiceal abscess (n=1), appendicitis (n=2), intraabdominal and rectus muscle abscess (n=1), intussusception (n=1), ulcerative colitis (n=1), Crohn's disease with diffuse peritoneal inflammation (n=3). 19 patients underwent to surgery or interventional therapy and 15 to follow-up. The sensitivity, specificity, accuracy, positive predictive values (ppv), and negative predictive values (npv) of MR imaging were 90.0% vs. 88.9%, 98.1% vs. 95.0%, 97.5% vs. 94.1%, 81.8% vs. 76.2%, 99.1% vs. 97.9%, respectively.  

The intrinsic safety of MRI and its ability to accurately show pelvic disease in pregnant patients make it highly useful in the evaluation of these patients.

MR can be useful in triage of pregnant patients with acute abdominal pain.  

Masselli, G, Casciani, E, Polettini, E, Bertini, L, Gualdi, G, MR Imaging in the Evaluation of Pregnant Patient with Acute Abdominal Pain.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8016668.html