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Practice Patterns in Imaging of the Pregnant Patient with Abdominal Pain: A Survey of Academic Centers

¹ All authors: Department of Radiology, Duke University Medical Center, Erwin Rd., Box 3808, Durham, NC 27710.

OBJECTIVE. The purpose of our study was to evaluate current practice patterns in the imaging of pregnant women with abdominal complaints.

MATERIALS AND METHODS. A survey was sent to the abdominal imaging division of 183 radiology residency programs in the United States. The survey asked for information regarding CT and MRI of abdominal complaints in pregnant patients.

RESULTS. Eighty-five surveys (46%) were returned. Sixty-three (74%) of 85 of respondents have a written departmental policy regarding imaging pregnant women. Eighty-two (96%) of 85 perform CT in pregnant women when benefits outweigh risks, with 58 (68%) obtaining written informed consent before CT examination. Eighty (94%) of 85 perform MRI in pregnant women, and 43 (51%) obtain written consent before MRI. Fifty-seven (67%) of 85 respondents do not administer gadolinium in pregnancy. In the setting of trauma, respondents choose CT over MRI for imaging in all three trimesters (75% vs 5%, 85% vs 5%, and 88% vs 4%). In the second and third trimesters, respondents prefer CT to MRI to evaluate for maternal renal calculus (35% vs 20% and 48% vs 18%, respectively), appendicitis (48% vs 38% and 58% vs 29%), and abscess (49% vs 41% and 58% vs 35%). However, MRI is preferred for imaging of appendicitis and abscesses in the first trimester (39% vs 32% and 46% vs 32%).

CONCLUSION. Most academic radiology departments have written policies regarding imaging of pregnant women. Academic radiologists prefer CT to MRI for imaging abdominal complaints in pregnant women, especially in the second and third trimesters.

Keywords: abdominal pain • CT • MRI • pregnancy

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