Imaging in pregnancy TOG 2019 Flashcards

1
Q

A fetus is exposed to how much background radiation in pregnancy?

A

1mGy

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2
Q

2 main units to measure radiation, what are they measuring?

A

Gray (Gy) - measures dose per KG of tissue. 1000mGy = 1Gy. 1Gy = 100 rad

Sievert (Sv) measures relative effective dose, 1000mSv = 1Sv

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3
Q

When gestation if expose to radiation can cause miscarriage? Which dose?

A

3-4 weeks
>50-100mGy

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4
Q

When gestation if expose to radiation can cause congenital malformation and FGR? Which dose?

A

5-10 weeks
>200 mGy

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5
Q

When gestation if expose to radiation can cause Risk lower IQ & microcephaly? Which dose?

A

11-17 weeks
>200mGy

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6
Q

Which examination are consider very low dose examinations <0.1mGy

A

Cervical spine Xray
Chest XR
XR extremities
Mammogram
Head & Neck CT

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7
Q

Which examination are consider low to moderate 0.1-10mGy)

A
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8
Q

Which examinations are consider higher dose 10-50mGy

A
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9
Q

How much can lead shielding reduce the risk of radiation?

A

50%

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10
Q

What are the risk with USS?

A

Thermal effects on tissue
Mechanical effects - tissue cavitation.

Fetal CNS most susceptible to thermal injury.

Measured by Thermal Index and Mechanical Index

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11
Q

Which type of USS has lowest risk of temperature elevations? Which have higher?

A

Lower: B-mode
Higher: Colour Doppler, spectral doppler

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12
Q

Is MRI safe in pregnancy?

A

Does not use radiation, magnetic fields.
Considered safe, some concerns with use in 1st trimester but not concrete evidence

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13
Q

Can gadolinium be used in pregnancy?

A

Advised not to use if can be avoided. Some studies showed higher risk inflammation conditions, risk stillbirth.

Gadolinium cross placenta in 2nd & 3rd trimester

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14
Q

How much fetal exposure to radiation in V/Q scan?

A

<5mGy

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15
Q

Can radioactive iodine be used in pregnancy

A

No may cause fetal hypothyroidism esecptiall after 12 weeks

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16
Q

Can PET CT be performed

A

Safety data, radiation low.
Can be used if needed

17
Q

What proportion go pregnancy with suspected VTE is confirmed on imaging?

A

2-6%

18
Q

How often inconclusive result from V/Q scan and CTPA

A

V/Q 4%
CTPA 6%

19
Q

Benefits/Disad CTPA

A

Availability
Low fetal radiation
Better identifying other pathology

Exposure 20mGy to maternal breast tissues - increase risk 13.6% of breast cancer

20
Q

Benefits/Dis Ad VQ

A

Benefite - higher NPP, no radiation to breast
Disad: Risk childhood malignancy but very low - 1 in 170000 per mGy and 0.0006% per mGy used

21
Q

How to assess breast mass in prengnacy

A

USS + Tissue Bx
If breast cancer suspected - mammogram

22
Q

Sensitivity of mammogram in pregnancy?

A

78-90%

23
Q

Staging of breast cancer in pregnancy

A

CXR & liver USS