Neuroimaging During Pregnancy and Lactation

Created 06/06/2022, last revision 04/05/2023

ultrasound and magnetic resonance imaging (MRI) are not associated with increased risk and are the imaging modalities of choice for pregnant women (ACOG Guidelines 2017)
still, they should be used with caution (especially MRI) and only when their use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient

Computed tomography (CT)

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Magnetic resonance imaging (MRI)

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Neurosonology

neurosonology is entirely safe for both the mother and the fetus – it is the preferred method for diagnosis and monitoring of occlusions and stenoses during pregnancy
ultrasound is also a safe method for examination of the fetus – the ALARA principle should be followed with regard to the amount of energy (max intensity < 720 mW/cm²)
- thermal effect on the fetus is highest with the color and Doppler mode and lowest with the B mode – use obstetric presets

Angiography (DSA)

mostly reserved for interventional procedures only – e.g., mechanical thrombectomy (MT), etc.
- pregnant women were excluded from randomized trials with MT, but the benefit can be assumed ⇒ pregnancy is, therefore, a relative contraindication to MT
- published case reports show good maternal and fetal outcomes [Blythe, 2019]
careful fetal shielding with a lead apron is required!