Radiological Evaluation of Neurological Disorders in Pregnancy and Postpartum

The use of radiologic examinations in pregnant patients has increased by 107 % during the past decade (Lazarus E et al., 2009). Magnetic resonance (MR) imaging and computed tomography (CT) to a lesser extent have become the primary workhorses used to asses neurologic conditions in pregnancy. The effective incorporation of CT and MRI into evaluation algorithms facilitates maximal diagnostic efficiency while minimizing potential risks to the mother and fetus. With the use of the ALARA (as low as reasonably achievable) principle, CT can be used safely to evaluate the mother’s head and neck during pregnancy. During CT of the head and neck, the fetus is excluded from the scanning field, and thus its radiation exposure is limited to a very low scattered dose (American College of Radiology Guidelines, 2008). CT is commonly used to diagnose acute neurologic conditions, especially in cases of trauma and suspected hemorrhage. MR imaging does not involve radiation exposure and enables excellent soft-tissue differentiation, it has better diagnostic accuracy and is considered the modality of choice for imaging in pregnant women (Tremblay E et al., 2012). MR imaging performed by using a 1.5 tesla magnet is safe for women during any trimester of pregnancy (De Wilde JP et al., 2005). Intravenously administered contrast material, whether iodinated or gadolinium-based, should be used judiciously, and its use is recommended only for those cases in which it is essential for the diagnosis.