Tarannum Asma, Sheikh Haifa, Appiah-Sakyi Kwabena, Lindow Stephen W
Womens Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar.
Womens Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar.
Eur J Obstet Gynecol Reprod Biol. 2020 Mar;246:177-180. doi: 10.1016/j.ejogrb.2019.11.027. Epub 2019 Nov 22.
Acute abdomino-pelvic pain in pregnancy represents a diagnostic challenge. In many cases, radiological and laparoscopic diagnostic modalities are hazardous or contraindicated. Magnetic Resonance Imaging (MRI) is not commonly used for this indication and the results are not widely published.
A single-center retrospective observational study.
34 cases of pregnant women with abdomino-pelvic pain who underwent MRI as an additional modality when clinical, laboratory and ultrasound (USS) findings were indeterminate.
Case notes were reviewed where pregnant women underwent a MRI investigation for abdominal-pelvic pain. Primary Obstetric indications for an MRI eg placenta accreta were excluded.
The differential diagnosis after; 1) history and physical examination and 2) with the addition of USS and 3) with the further addition of an MRI were all individually compared to the eventual diagnosis.
The diagnoses reached by MRI corresponded with the final diagnosis in 22 out of 23 cases. In the remaining 11 cases MRI accurately ruled out presence of pathology. MRI was inaccurate in 1 case.
The additional use of MRI was more accurate than clinical assessment and USS combined. The accurate exclusion of pathology in 11 cases is particularly significant. MRI should be considered in cases of abdomino-pelvic pain in pregnant women.
孕期急性腹盆腔疼痛是一项诊断挑战。在许多情况下，放射学和腹腔镜诊断方式具有危险性或属禁忌。磁共振成像（MRI）通常不用于此适应证，且相关结果发表并不广泛。
一项单中心回顾性观察研究。
34例腹盆腔疼痛的孕妇，当临床、实验室及超声（USS）检查结果不明确时，将MRI作为补充检查手段。
回顾孕妇因腹盆腔疼痛接受MRI检查的病历记录。排除MRI的主要产科适应证，如胎盘植入。
分别将1）病史及体格检查后、2）加上USS检查后、3）再加上MRI检查后的鉴别诊断结果与最终诊断进行比较。
23例中有22例MRI得出的诊断与最终诊断相符。其余11例中，MRI准确排除了病变存在。有1例MRI诊断不准确。
额外使用MRI比临床评估及USS联合检查更准确。11例中准确排除病变尤其重要。对于孕妇腹盆腔疼痛病例，应考虑使用MRI。
