Fast MR Imaging in Obstetrics

Abstract

Ultrasonography (US) is the initial imaging modality of choice for evaluation of patients in obstetrics. However, the results of US are not always sufficient. Magnetic resonance (MR) imaging, which uses no ionizing radiation, may be an ideal method for further evaluation. Although MR imaging is not recommended during the first trimester and use of contrast material is not recommended in pregnant patients, fast MR imaging is useful in various obstetric settings and can provide more specific information with excellent tissue contrast and multiplanar views. In pregnant patients with acute conditions, various diseases (eg, red degeneration of a uterine leiomyoma) may be diagnosed. MR imaging allows characterization of pelvic masses discovered during pregnancy and diagnosis of postpartum complications (eg, abscess, hematoma, ovarian vein thrombosis). In pregnant patients with hydronephrosis, MR urography can demonstrate the site of obstruction and the cause (eg, a ureteral stone). MR pelvimetry may be beneficial in cases of breech presentation. Contrast material-enhanced dynamic MR imaging allows one to evaluate the vascularity of a placental polyp, detect the viable component of a gestational trophoblastic tumor, and diagnose a uterine arteriovenous malformation. MR imaging enables diagnosis of rare forms of ectopic pregnancy and early diagnosis of ectopic pregnancy.

Interstitial pregnancy: role of MRI

“…It has been established that tubal wall enhancement and fresh tubal hematoma were specific for ectopic pregnancy, whereas a gestational sac-like structure without tubal structure was equivocal because of the differential diagnosis of cystic masses of the ovary [6]. By contrast, little has been reported about MRI findings in interstitial pregnancy [3,4]. These two cases confirm that the presence of a junctional zone between the gestational sac surrounded by myometrium and the uterine cavity is very suggestive of interstitial pregnancy.…”

“…MR imaging is not usually essential for diagnosis. However, it may be useful for specific diagnosis of rare or complicated forms of ectopic pregnancy [3][4][5]. We report two cases that illustrate the features and the contribution of MRI in the diagnosis of interstitial pregnancy.…”

Uterine arteriovenous malformation-beyond surgery: a case series

“…Post contrast there is intense enhancement of the serpentine vessels with early venous return. 13 Gestational trophoblastic disease can co-exist and/or present with similar clinical and imaging appearance, which necessitates serial monitoring of Beta HCG levels as was noted in one of our patients.…”

MRI for Suspected Appendicitis in Pregnancy

“…The inflamed appendix has thickened wall and alter signal characteristic with increased signal intensity on T2-weighted imaging (Figure 2 and 3) [15]. To date, there is no biological evidence showing that MRI is harmful for the fetus [16,17]. But we still need to reduce the time period in the MRI examination because of noise stimulation and potential heat.…”