Year: 2005
Type: article
Abstract: Sonography is the screening method of choice in evaluation of the adnexae, uterus, and fetus. However, there are circumstances in which an alternate imaging modality is needed. Pelvic MR uses no ionizing radiation, provides excellent soft tissue contrast, and has multiple planes for reconstruction. Fetal MR is increasingly being utilized for assessment of fetuses with complex diagnoses. This talk illustrates use of MR in complex pelvic pathology and in pregnancy. MR is felt to be safe for use in pregnancy. MR allows for specific diagnosis in cases of complex adnexal masses such as pedunculated fibroids and dermoids that can allow for surgery to be avoided. MR can be utilized for pelvimetry, for assessment of placental abruption, and placenta accreta, and for assessment of abdominopelvic pain in pregnancy (ureteral stones, choledocholithiasis, appendicitis, and intestinal obstruction). Perhaps the most exciting use of MR in pregnancy is to evaluate the fetus. Images are obtained in less than 1 second so it is not necessary to sedate either mother or the fetus. Examples of cases where MR made a difference in patient management in CNS anomalies were fetuses with mild ventriculomegaly with associated finding such as porencephaly; fetuses with megacisterna magna, in whom the posterior fossa was difficult to evaluate late in gestation; in fetuses with small head on sonography, and in screening for tuberous sclerosis. Because of the risk to both the fetus and the mother whenever fetal surgery is performed, MR is very helpful to exclude abnormalities that would obviate the need for surgery, and to obtain detailed views of the fetal anatomy to better plan for surgery. Ultrasound will continue to be the modality of choice in the evaluation of the pelvis in pregnant and nonpregnant patients. As our experience with fast MR techniques increases we will continue to identify cases in which MR will aid in patient care.
DOI: 10.1002/uog.2001
Author: D. Levine
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1994426435