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妊娠和产褥期急性腹盆腔疼痛的影像学检查——第二部分:非产科并发症

Imaging of Acute Abdominopelvic Pain in Pregnancy and Puerperium-Part II: Non-Obstetric Complications.

作者信息

Masselli Gabriele, Bonito Giacomo, Gigli Silvia, Ricci Paolo

机构信息

Department of Emergency Radiology-Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.

Department of Diagnostic Imaging, Sandro Pertini Hospital, Via dei Monti Tiburtini 385, 00157 Rome, Italy.

出版信息

Diagnostics (Basel). 2023 Sep 11;13(18):2909. doi: 10.3390/diagnostics13182909.

Abstract

Emergency imaging in pregnancy and puerperium poses unique challenges both for clinicians and radiologists, requiring timely and accurate diagnosis. Delay in treatment may result in poor outcomes for both the patient and the foetus. Pregnant and puerperal patients may present in the emergency setting with acute abdominopelvic pain for various complications that can be broadly classified into obstetric and non-obstetric related diseases. Ultrasonography (US) is the primary diagnostic imaging test; however, it may be limited due to the patient's body habitus and the overlapping of bowel loops. Computed tomography (CT) carries exposure to ionising radiation to the foetus, but may be necessary in selected cases. Magnetic resonance imaging (MRI) is a valuable complement to US in the determination of the etiology of acute abdominal pain and can be used in most settings, allowing for the identification of a broad spectrum of pathologies with a limited protocol of sequences. In this second section, we review the common non-obstetric causes for acute abdominopelvic pain in pregnancy and post partum, offering a practical approach for diagnosis and pointing out the role of imaging methods (US, MRI, CT) with the respective imaging findings.

摘要

孕期和产褥期的急诊成像对临床医生和放射科医生来说都带来了独特的挑战,需要及时准确的诊断。治疗延误可能会给患者和胎儿带来不良后果。怀孕和产褥期的患者在急诊时可能因各种并发症而出现急性腹盆腔疼痛,这些并发症大致可分为产科和非产科相关疾病。超声检查(US)是主要的诊断成像检查;然而,由于患者的体型和肠袢重叠,其可能存在局限性。计算机断层扫描(CT)会使胎儿暴露于电离辐射,但在某些特定情况下可能是必要的。磁共振成像(MRI)在确定急性腹痛病因方面是超声检查的重要补充,并且在大多数情况下都可使用,通过有限的序列方案就能识别多种病变。在本节中,我们回顾了孕期和产后急性腹盆腔疼痛的常见非产科病因,提供了一种实用的诊断方法,并指出成像方法(超声、MRI、CT)的作用以及各自的成像表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2153/10528125/8601d68ec81d/diagnostics-13-02909-g001.jpg

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