妊娠患者急性腹痛的影像学评估
妊娠期急性腹痛诊断困难，生理适应和子宫增大可混淆体征。US和MRI为首选，CT在特定时效性情况下仍适用，尤其MRI不可用或疑穿孔、缺血、复杂梗阻时。病因包括产科、胃肠、泌尿及血管病变，及时诊断对母婴结局至关重要。
要点
- US和MRI是妊娠期急性腹痛的首选影像检查。
- CT在疑穿孔、缺血、复杂梗阻或MRI不可用时仍可选用。
- 妊娠期腹痛病因需涵盖产科、胃肠、泌尿及血管病变。
核心结论
- 妊娠期急性腹痛影像评估应首选US和MRI，CT在特定时效性情况下仍适用。
研究设计与样本
- 本文为综述，探讨妊娠期急性腹盆腔病变的影像评估，未报告具体样本量、中心数或设备序列。
临床应用与阅片要点
- 日常阅片应优先选择US和MRI评估妊娠期腹痛，避免不必要辐射。
- 当疑穿孔、缺血、复杂梗阻或MRI不可用时，CT的获益可能大于风险，应合理选用。
- 报告需结合妊娠生理变化，注意鉴别产科、胃肠、泌尿及血管病因。
局限性
- 本文为综述，未提供原始研究数据或定量证据。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
Acute abdominal and pelvic pain during pregnancy presents a unique diagnostic challenge. Many pathologies may mimic signs and symptoms attributed to maternal physiologic adaptations and physical examination findings can be confounded by the gravid uterus. While US and MRI are preferred first-line imaging modalities, CT remains appropriate in selected time-sensitive situations when benefits outweigh risks, particularly when MRI is unavailable or for suspected perforation, ischemia, or complicated obstruction. Etiologies are variable and include obstetric-gynecologic disorders as well as other common entities such as gastrointestinal (including hepatobiliary), genitourinary, or even vascular causes. Prompt diagnosis plays a crucial role in appropriate treatment to ensure optimal maternal and fetal outcomes. This paper will explore the depth and breadth of acute abdominopelvic pathologies during pregnancy.
引用
- Czerniak S, Entezari P, Moazeni Y, et al. Imaging evaluation of acute abdominal pain in the pregnant patient. Abdom Radiol (NY). 2026. PMID: 42009971. doi:10.1007/s00261-026-05525-x
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。