Seminars in Ultrasound, CT and MRI
Volume 33, Issue 1 , Pages 11-17 , February 2012

Pulmonary Embolism Evaluation in the Pregnant Patient: A Review of Current Imaging Approaches

  • Jonathan R. Cogley, MD

      Affiliations

    • Department of Radiology, Baystate Medical Center, Western Campus of Tufts University, School of Medicine, Springfield, MA
    • Corresponding Author InformationAddress reprint requests to Jonathan R. Cogley, MD, Department of Radiology, Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199
    • ,
  • Peter M. Ghobrial, MD

      Affiliations

    • Department of Radiology, Baystate Medical Center, Western Campus of Tufts University, School of Medicine, Springfield, MA
    • ,
  • Bharanidhar Chandrasekaran, MD

      Affiliations

    • Baystate Hospital Medicine, Baystate Health System, Springfield, MA
    • ,
  • Steven B. Allen, MD

      Affiliations

    • Department of Radiology, Baystate Medical Center, Western Campus of Tufts University, School of Medicine, Springfield, MA

References 

  1. Sadigh G , Kelly AM , Cronin P . Challenges, controversies, and hot topics in pulmonary embolism imaging . AJR Am J Roentgenol . 2011;196:497–515
  2. Duhl AJ , Paidas MJ , Ural SH , et al.  Antithrombotic therapy and pregnancy: Consensus report and recommendations for prevention and treatment of venous thromboembolism and adverse pregnancy outcomes . Am J Obstet Gynecol . 2007;197:457.e1–457.e21
  3. Yousefzadeh DK , Ward MB , Reft C . Internal barium shielding to minimize fetal irradiation in spiral chest CT: A phantom simulation experiment . Radiology . 2006;239:751–758
  4. Winer-Muram HT , Boone JM , Brown HL , et al.  Pulmonary embolism in pregnant patients: Fetal radiation dose with helical CT . Radiology . 2002;224:487–492
  5. Miller MA , Chalhoub M , Bourjeily G . Peripartum pulmonary embolism . Clin Chest Med . 2011;32:147–164
  6. Rosenberg VA , Lockwood CJ . Thromboembolism in pregnancy . Obstet Gynecol Clin North Am . 2007;34:481–500
  7. Revel MP , Cohen S , Sanchez O , et al.  Pulmonary embolism during pregnancy: Diagnosis with lung scintigraphy or CT angiography? . Radiology . 2011;258:590–598
  8. Stein PD , Woodard PK , Weg JG , et al.  Diagnostic pathways in acute pulmonary embolism: Recommendations of the PIOPED II Investigators . Radiology . 2007;242:15–21
  9. Freeman LM . Don't bury the V/Q scan: It's as good as multidetector CT angiograms with a lot less radiation exposure . J Nucl Med . 2008;49:5–8
  10. Shahir K , Goodman LR , Tali A , et al.  Pulmonary embolism in pregnancy: CT pulmonary angiography versus perfusion scanning . AJR Am J Roentgenol . 2010;195:214–222
  11. Stein PD , Fowler SE , Goodman LR , et al.  Multidetector computed tomography for acute pulmonary embolism . N Engl J Med . 2006;354:2317–2327
  12. Sostman HD , Stein PD , Gottschalk A , et al.  Acute pulmonary embolism: Sensitivity and specificity of ventilation-perfusion scintigraphy in PIOPED II study . Radiology . 2008;246:941–946
  13. Bourjeily G , Chalhoub M , Phornphutkul C , et al.  Neonatal thyroid function: Effect of a single exposure to iodinated contrast medium in utero . Radiology . 2010;256:744–750
  14. Hagen PJ , Hartmann IJ , Hoekstra OS , et al.  Comparison of observer variability and accuracy of different criteria for lung scan interpretation . J Nucl Med . 2003;44:739–744
  15. Ridge CA , McDermott S , Freyne BJ , et al.  Pulmonary embolism in pregnancy: Comparison of pulmonary CT angiography and lung scintigraphy . AJR Am J Roentgenol . 2009;193:1223–1227
  16. Schaefer-Prokop C , Prokop M . CTPA for the diagnosis of acute pulmonary embolism during pregnancy . Eur Radiol . 2008;18:2705–2708
  17. Kuzo RS , Pooley RA , Crook JE , et al.  Measurement of caval blood flow with MRI during respiratory maneuvers: Implications for vascular contrast opacification on pulmonary CT angiographic studies . AJR Am J Roentgenol . 2007;188:839–842
  18. Lazarus E , DeBenedectis C , North D , et al.  Utilization of imaging in pregnant patients: 10-Year review of 5270 examinations in 3285 patients—1997-2006 . Radiology . 2009;251:517–524
  19. Groves AM , Yates SJ , Win T , et al.  CT pulmonary angiography versus ventilation-perfusion scintigraphy in pregnancy: Implications from a UK survey of doctors' knowledge of radiation exposure . Radiology . 2006;240:765–770
  20. Hurwitz LM , Yoshizumi T , Reiman RE , et al.  Radiation dose to the fetus from body MDCT during early gestation . AJR Am J Roentgenol . 2006;186:871–876
  21. Patel SJ , Reede DL , Katz DS , et al.  Imaging the pregnant patient for nonobstetric conditions: Algorithms and radiation dose considerations . Radiographics . 2007;27:1705–1722
  22. Wang F , Fang W , Lv B , et al.  Comparison of lung scintigraphy with multi-slice spiral computed tomography in the diagnosis of pulmonary embolism . Clin Nucl Med . 2009;34:424–427
  23. Kline JA , Courtney DM , Beam DM , et al.  Incidence and predictors of repeated computed tomographic pulmonary angiography in emergency department patients . Ann Emerg Med . 2009;54:41–48

PII: S0887-2171(11)00117-X

doi: 10.1053/j.sult.2011.09.001

Seminars in Ultrasound, CT and MRI
Volume 33, Issue 1 , Pages 11-17 , February 2012

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