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MRI of Acute Abdominal and Pelvic Pain in Pregnant Patients

Katherine R. Birchard1, Michele A. Brown1,2, W. Brian Hyslop1, Zeynep Firat1 and Richard C. Semelka1

1 Department of Radiology, University of North Carolina Hospitals, 101 Manning Dr., 2006 Old Clinic Bldg., Chapel Hill, NC 27599-7510.
2 Department of Radiology, University of California at San Diego, San Diego, CA.



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  		Fig. 1A. —27-year-old woman at 31 weeks' gestation with right-sided abdominal pain. Transverse fat-suppressed images obtained after gadolinium administration show intensely enhancing small segment of intestinal tract (arrow, A) that terminates in subhepatic fluid collection more superiorly (arrow, B)

 


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  		Fig. 1B. —27-year-old woman at 31 weeks' gestation with right-sided abdominal pain. Transverse fat-suppressed images obtained after gadolinium administration show intensely enhancing small segment of intestinal tract (arrow, A) that terminates in subhepatic fluid collection more superiorly (arrow, B)

 


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  		Fig. 1C. —27-year-old woman at 31 weeks' gestation with right-sided abdominal pain. Sagittal fat-suppressed image obtained after gadolinium administration shows continuity between small-caliber viscus structure (thin arrows) and subhepatic fluid collection (thick arrow).

 


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  		Fig. 2A. —31-year-old woman at 23 weeks' gestation with severe left-sided abdominal pain. Sagittal and transverse HASTE images show intussusception of small bowel in left upper quadrant. Note dilated loops of small bowel and free fluid.

 


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  		Fig. 2B. —31-year-old woman at 23 weeks' gestation with severe left-sided abdominal pain. Sagittal and transverse HASTE images show intussusception of small bowel in left upper quadrant. Note dilated loops of small bowel and free fluid.

 


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  		Fig. 3A. —29-year-old woman at 14 weeks' gestation with history of abdominal pain and diarrhea. Transverse HASTE image shows bowel wall thickening (arrows).

 


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  		Fig. 3B. —29-year-old woman at 14 weeks' gestation with history of abdominal pain and diarrhea. Transverse fat-suppressed image obtained after gadolinium administration shows moderately intense mucosal and serosal enhancement (arrows) of bowel, which is consistent with acute active disease. Submucosal sparing, as shown in this case, is consistent with ulcerative colitis rather than Crohn's disease, which generally shows transmural involvement.

 


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  		Fig. 4. —24-year-old woman at 25 weeks' gestation with diffuse abdominal pain and peritoneal signs. Transverse T1-weighted image obtained after gadolinium administration shows free fluid in abdomen, thickening of bowel walls, and diffuse enhancement of peritoneum.

 


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  		Fig. 5A. —19-year-old woman at 21 weeks' gestation with right lower quadrant pain and fever. Coronal unenhanced T1-weighted (A) and T2-weighted (B) images show enlarged right kidney with surrounding perinephric fluid (arrows), which is consistent with pyelonephritis.

 


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  		Fig. 5B. —19-year-old woman at 21 weeks' gestation with right lower quadrant pain and fever. Coronal unenhanced T1-weighted (A) and T2-weighted (B) images show enlarged right kidney with surrounding perinephric fluid (arrows), which is consistent with pyelonephritis.

 


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  		Fig. 6A. —30-year-old woman at 15 weeks' gestation with sharp intermittent right lower quadrant pain. Transverse HASTE image shows normal left ovary with normal follicles and stroma (arrow).

 


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  		Fig. 6B. —30-year-old woman at 15 weeks' gestation with sharp intermittent right lower quadrant pain. Transverse HASTE image shows enlarged and edematous right ovary (arrow), which is consistent with torsion.

 

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