Imaging Pregnant Patients with Suspected Pulmonary Embolism: What the Radiologist Needs to Know

Pregnancy is associated with a fivefold increase in the prevalence of venous thromboembolism, and pulmonary embolism is a leading cause of maternal death. However, the diagnosis of pulmonary embolism during pregnancy is challenging because classic clinical symptoms are often absent and physiologic changes during pregnancy can mimic pulmonary embolism. Concerns about exposure of the fetus to ionizing radiation and intravenously administered contrast material, as well as potential medicolegal issues, further complicate the diagnosis. Although diagnostic imaging plays an important role in this setting, there are currently no widely accepted guidelines for radiologists and clinicians to follow. Thus, radiologists should be familiar with the advantages and disadvantages of available imaging modalities, methods for dose reduction, radiation risks, and medicolegal risk management guidelines. © RSNA, 2009