NEUROIMAGING

Neuroimaging During Pregnancy and Lactation

Created 06/06/2022, last revision 21/12/2022

Guidelines for Diagnostic Imaging During Pregnancy and Lactation

  • ultrasonography and magnetic resonance imaging (MRI) are not associated with an increased risk and are the imaging modalities of choice for pregnant women (ACOG Guidelines 2017)
    • still, use them 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
Fetal radiation dose caused by different diagnostic methods
Computed tomography (CT)
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Magnetic resonance imaging (MRI)
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Neurosonology
  • neurosonology is entirely safe for both mother and the fetus – it is the preferred method in the diagnosis and monitoring of occlusions and stenoses during pregnancy
  • ultrasound it is also a secure method for fetus examination – in terms of the amount of energy, follow the ALARA principle (max intensity < 720 mW/cm2)
    • thermal effect on the fetus si highest with the color and Doppler mode, 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 lead apron is required!
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Neuroimaging during pregnancy and lactation
link: https://www.stroke-manual.com/neuroimaging-during-pregnancy-and-lactation/