Normal MRI abdomen in pregnancy

Case contributed by Vikas Shah

Presentation

12/40 pregnant. Lower abdominal pain.

Patient Data

Age: 25 years
Gender: Female

MRI

mri

Intrauterine pregnancy confirmed but not interrogated in detail. The appendix is identified lying inferior to the cecal pole, with normal thickness and no luminal distension. There is no surrounding edema or free fluid, and no restricted diffusion. Incidental note is made of distension of the right ovarian vein.

Case Discussion

The appendix may not be clearly identified on MRI in pregnancy for a number of reasons, including the limited spatial resolution compared to CT, and the alteration in anatomy caused by the gravid uterus. In this case, it is seen inferior to the cecum. The absence of ancillary signs of acute appendicitis such as edema and fluid in the region of the cecal pole is helpful in confirming that there is no acute appendicitis. The pregnancy progressed to term with no requirement for surgical intervention.

This study also demonstrated an engorged right ovarian vein, seen here as high signal on the gradient echo images, but predominantly low signal on the SSFSE image, due to flow voids.

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