MR-Diagnostik des Abdomens in der Schwangerschaft

Zusammenfassung

In der radiologischen Diagnostik akuter Erkrankungen der Schwangeren ist die Sonografie die Methode der ersten Wahl. Die veränderte Physiognomie der Frauen verstärkt die bekannten Limitationen des Ultraschalls, während die Stärken der MRT (großes FOV, hoher Weichteilkontrast, sensitive Ödemdarstellung) durch die Schwangerschaft nicht beeinträchtigt werden. Vielmehr ermöglichen die zur Verfügung stehenden Sequenzen die sichere Differenzierung verschiedener Pathologien. Bei vielen Fragestellungen kann auf die KM-Gabe verzichtet werden, was den nicht invasiven Charakter der MRT noch einmal unterstreicht. Der genaue Stellenwert von DWI oder ASL ist noch nicht systematisch untersucht, erste Beschreibungen sind jedoch vielversprechend, sodass der Stellenwert der MRT bei Schwangeren in der Zukunft noch zunehmen wird. Kenntnisse über die häufigsten Erkrankungen während der Schwangerschaft und deren MR-Morphologie sind daher auch für den Radiologen von Bedeutung. Die Vorteile der MRT gegenüber der Sonografie und der hieraus abzuleitende Stellenwert in der Schwangerschaft werden in diesem Artikel unter Berücksichtigung moderner Sequenztechniken diskutiert.

Abstract

Sonography is still the method of choice for imaging diseases in pregnant women. The changed physiognomy of the women increases the known limitations of sonography while the advantages of MRI (large field of view, excellent soft-tissue contrast, sensitive diagnosis of edema) are not affected. The available sequences allow the differentiation of various pathologies. Most of these can frequently be visualized without intravenous administration of contrast material. Although the significance of techniques like DWI and ASL has not yet been explored, initial descriptions are promising and MR imaging in pregnancy will be increasingly important in the future. Therefore, knowledge of the most frequent diseases in pregnancy and their image appearance is relevant to radiologists. The advantages of MRI in comparison to sonography and its important role in imaging pathologies of the acute abdomen in pregnancy are illustrated and discussed.

Key words

abdomen - pregnancy - MR diffusion/perfusion - MR imaging - safety

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