Hansen Wendy, Moshiri Mariam, Paladin Angelisa, Lamba Ramit, Katz Douglas S, Bhargava Puneet
University of Washington School of Medicine, Seattle, WA.
UC Davis Medical Center, Davis, CA.
Curr Probl Diagn Radiol. 2017 Jan-Feb;46(1):10-16. doi: 10.1067/j.cpradiol.2016.06.002. Epub 2016 Jun 22.
The purpose of our study was to determine the current practice patterns of U.S. radiologists in imaging pregnant or potentially pregnant patients with acute abdominal and pelvic conditions.
After obtaining an Institutional Review Board waiver, all members of the Association of University Radiologists, the Association of Program Directors in Radiology, and the Society of Radiologists in Ultrasound were invited via e-mail to take a 23-question online survey on radiology practices and clinical scenarios about acute abdominal and pelvic imaging of pregnant patients.
Comparisons were made with previously published surveys. A total of 225 responses were received. Areas of high consensus included pregnancy assessment (97%) and obtaining informed consent (87%) before imaging, having a written policy on imaging pregnant patients (79%), modification of computed tomography (CT) protocols (74%), avoiding gadolinium contrast in magnetic resonance imaging (MRI) (74%), using ultrasound for initial imaging in some scenarios, and using CT in trauma cases after inconclusive ultrasound. Areas of emerging consensus compared to 2007 included the use of serum or urine testing to confirm pregnancy status (59.4%; previously 14%) and the use of MRI in suspected appendicitis after an inconclusive ultrasound (73% in first trimester and 67% in third trimester; previously 46% and 29%, respectively). Areas without clear consensus included policy development, additional modifications to MRI protocols, choice of imaging modality, radiation dose, and the use of contrast agents in some scenarios.
In conclusion, high or increasing consensus exists in some areas of imaging pregnant patients with acute abdominal and pelvic conditions, but has yet to emerge in other areas.
我们研究的目的是确定美国放射科医生对患有急腹症和盆腔疾病的孕妇或可能怀孕患者进行成像检查的当前实践模式。
在获得机构审查委员会豁免后，通过电子邮件邀请大学放射科医生协会、放射学项目主任协会和超声放射科医生协会的所有成员参加一项关于放射学实践和孕妇急腹症及盆腔成像临床情景的23题在线调查。
与之前发表的调查进行了比较。共收到225份回复。高度一致的领域包括在成像前进行妊娠评估（97%）和获得知情同意（87%）、制定关于孕妇成像的书面政策（79%）、修改计算机断层扫描（CT）方案（74%）、在磁共振成像（MRI）中避免使用钆对比剂（74%）、在某些情况下使用超声进行初始成像以及在超声检查结果不明确的创伤病例中使用CT。与2007年相比出现一致意见的领域包括使用血清或尿液检测来确认妊娠状态（59.4%；之前为14%）以及在超声检查结果不明确的疑似阑尾炎中使用MRI（孕早期为73%，孕晚期为67%；之前分别为46%和29%）。没有明确一致意见的领域包括政策制定、对MRI方案的进一步修改、成像方式的选择、辐射剂量以及在某些情况下使用对比剂。
总之，在对患有急腹症和盆腔疾病的孕妇进行成像检查的某些领域存在高度或日益增长的共识，但在其他领域尚未形成。
