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There is a constantly evolving knowledgebase regarding the safety of MRI in pregnant patients, as well as the safety of gadolinium administration, given potential fetal risks. This review provides an overview of national and international recommendations for patient screening and safety by trimester, evaluates the most recent literature regarding administration of gadolinium in pregnant patients, and discusses technical requirements when imaging pregnant patients. A protocol for imaging pregnant patients is provided, and multiple common indications for MRI in pregnancy are discussed. Level of Evidence 5. Technical Efficacy Stage 5. J. Magn. Reson. Imaging 2019;49:621–631.

Patients premedicated for a previous reaction to iodinated contrast material have a breakthrough reaction rate 3-4 times the ordinary reaction rate in the general population. Patients receiving premedication for other reasons have a breakthrough reaction rate near 0%. Many patients must receive premedication to prevent one reaction.

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Purpose:To estimate the effect of an oral 13-hour inpatient corticosteroid premedication regimen on length of stay, hospital cost, and hospital-acquired infections (HAIs) by using a combination of real and hypothetical study populations. Materials and Methods:Institutional review board approval was obtained and informed consent waived for this HIPAA-compliant retrospective study. Inpatients who received an oral 13-hour corticosteroid premedication regimen before contrast material-enhanced CT (n = 1424) from 2008 to 2013 were matched by age, sex, and year when CT was performed to a control cohort (n = 1425) of patients who underwent contrast-enhanced CT without premedication and who had similar rates of 13 comorbid diseases. Length of stay in the hospital and time from admission to CT were compared by using the Mann-Whitney U test. Rates of prospectively reported HAIs were compared by using x 2 tests. The indirect cost and risk of HAI with premedication were estimated by using published data. Results:Premedicated inpatients had a significantly longer median length of stay (+25 hours; 158 vs 133 hours, P , .001), a significantly longer median time to CT (+25 hours, 42 vs 17 hours, respectively; P , .001), and a significantly greater risk of HAI (5.1% [72 of 1424] vs 3.1% [44 of 1424], respectively; P = .008) compared with nonpremedicated control subjects. On the basis of these data and existing references, the prolonged length of stay was estimated to result in 0.04 HAI-related deaths and a cost of $159 131 (in U.S. dollars) for each prevented reaction of any severity and 32 HAI-related deaths and a cost of $131 211 400 for each prevented reaction-related death. Conclusion:Oral 13-hour inpatient corticosteroid prophylaxis is associated with substantial cost relative to its modest benefit, and may cause more indirect harm than the direct harm that it prevents.q RSNA, 2015

BACKGROUND Pulmonary hypertension and right ventricular failure are major contributors to morbidity and mortality in chronic lung disease. Therefore, large animal models of pulmonary hypertension and right ventricular hypertrophy are needed to study underlying disease mechanisms and test new treatment modalities. The objective of this study was to create a low-mortality model of chronic pulmonary hypertension and right ventricular hypertrophy in sheep. METHODS The vena cavae of nine sheep weighing 62 ± 2 (SEM) kg were injected with 0.375 g of dextran beads (sephadex) everyday for 60 days. Pulmonary hemodynamics were assessed via pulmonary artery catheterization prior to the first injection and again on days 14, 28, 35, 42, 49, and 56. At the end of the experiment, the heart was removed, dissected, and weighed to determine the ratio of right ventricular mass to left ventricle plus septal mass (RV:LV+S). RESULTS All sheep survived to 60 days. The average pulmonary artery pressure rose from 17 ± 1 mmHg at baseline to 35 ± 3 mmHg on day 56 with no significant change in cardiac output (8.7 ± 0.7 to 9.8 ± 0.7 L/min, p = 0.89). The RV:LV+S was significantly higher (0.42 ± 0.01, p < 0.001) than a historic group of untreated normal animals (0.35 ± 0.01, n = 13). CONCLUSIONS This study provides a low-mortality large animal model of moderate chronic pulmonary hypertension and right ventricular hypertrophy.