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Acute abdominal and pelvic pain in pregnancy: MR imaging as a valuable adjunct to ultrasound?

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Abstract

Background

To investigate the usefulness of magnetic resonance imaging (MRI) in the evaluation of pregnant women with acute abdominal and pelvic pain after sonographically (US) indeterminate findings.

Methods

Forty pregnant patients with acute abdominal and/or pelvic pain, in whom ultrasound was indeterminate, were included in this study. Multiplanar MR images of the abdomen and pelvis were obtained and independently reviewed by two radiologists with discrepancies were resolved by consensus.

Results

Correlation of prospective clinical MR interpretations with surgical and obstetric records and clinical follow-up showed correct identification of disease entities in all 40/40 patients. The following disease processes were correctly identified using MRI in 21/40 patients: appendicitis (n = 5), ileal volvulus (n = 1), common bile duct lithiasis (n = 2), pubic chondrosarcoma (n = 1), uterine dehiscence (n = 1), placental hematoma (n = 3), iliac venous thrombosis (n = 2), ulcerative colitis (n = 1), acute pancreatitis (n = 1), hydronephrosis (n = 1), ovarian dermoid (n = 1), and ovarian torsion (n = 2). 19 of the 40 patients had normal findings on MR examinations and unremarkable follow-up. Interobserver agreement for lesion detection was excellent (0.95 k).

Conclusion

Magnetic resonance imaging (MRI) is an accurate investigation in detecting the cause of acute abdominal and pelvic pain during pregnancy and should be considered after US indeterminate findings.

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Authors and Affiliations

  1. Radiology DEA Department, Umberto I Hospital, La Sapienza University, Viale del Policlinico 155, 00161, Rome, Italy

    Gabriele Masselli, Emanuele Casciani, Elisabetta Polettini, Luca Bertini, Francesca Laghi & Gianfranco Gualdi

  2. Department of Gynecology and Obstetrics, Umberto I Hospital, La Sapienza University, Viale del Policlinico 155, 00161, Rome, Italy

    Roberto Brunelli & Maurizio Anceschi

Authors
  1. Gabriele Masselli
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  2. Roberto Brunelli
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  3. Emanuele Casciani
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  4. Elisabetta Polettini
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  5. Luca Bertini
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  6. Francesca Laghi
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  7. Maurizio Anceschi
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  8. Gianfranco Gualdi
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Corresponding author

Correspondence to Gabriele Masselli.

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Masselli, G., Brunelli, R., Casciani, E. et al. Acute abdominal and pelvic pain in pregnancy: MR imaging as a valuable adjunct to ultrasound?. Abdom Imaging 36, 596–603 (2011). https://doi.org/10.1007/s00261-010-9654-0

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  • DOI: https://doi.org/10.1007/s00261-010-9654-0

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