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Imaging the Pregnant Patient for Nonobstetric Conditions: Algorithms and Radiation Dose Considerations¹

¹ From the Department of Radiology, Long Island College Hospital, 339 Hicks St, Brooklyn, NY 11201 (S.J.P., D.L.R., R.S.); the Department of Radiology, Winthrop-University Hospital, Mineola, NY (D.S.K.); and the Department of Radiology, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ (J.K.A.). Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received January 5, 2007; revision requested February 12 and received April 4; accepted April 11. All authors have no financial relationships to disclose. Address correspondence to S.J.P. (e-mail: drshitalp{at}hotmail.com).

Use of diagnostic imaging studies for evaluation of pregnant patients with medical conditions not related to pregnancy poses a persistent and recurring dilemma. Although a theoretical risk of carcinogenesis exists, there are no known risks for development of congenital malformations or mental retardation in a fetus exposed to ionizing radiation at the levels typically used for diagnostic imaging. An understanding of the effects of ionizing radiation on the fetus at different gestational stages and the estimated exposure dose received by the fetus from various imaging modalities facilitates appropriate choices for diagnostic imaging of pregnant patients with nonobstetric conditions. Other aspects of imaging besides radiation (ie, contrast agents) also carry potential for fetal injury and must be taken into consideration. Imaging algorithms based on a review of the current literature have been developed for specific nonobstetric conditions: pulmonary embolism, acute appendicitis, urolithiasis, biliary disease, and trauma. Imaging modalities that do not use ionizing radiation (ie, ultrasonography and magnetic resonance imaging) are preferred for pregnant patients. If ionizing radiation is used, one must adhere to the principle of using a dose that is as low as reasonably achievable after a discussion of risks versus benefits with the patient.

© RSNA, 2007