medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-1408medvis-1408Research ArticleМАЛЫЙ ТАЗSMALL PELVISПоказания, ограничения и возможности применения методов лучевой диагностики у беременных женщинMedical visualization in pregnancy: indications, limitations and prospectshttps://orcid.org/0000-0003-4356-3690ПавловскаяЕ. А.PavlovskayaE. A.

Павловская Евгения Александровна – канд. мед. наук, врач-рентгенолог (кабинета МРТ) отделения лучевой диагностики ФГБУ “НМИЦ онкологии им. Н.Н. Петрова” Минздрава России, Санкт-Петербург. 

 

Evgenia A. Pavlovskaya – Cand. of Sci. (Med.), radiologist MRI-specialist, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg

e.a.pavlovskaya@gmail.comhttps://orcid.org/0000-0002-4131-6293БагненкоС. С.BagnenkoSergey S.

Багненко Сергей Сергеевич – доктор мед. наук, заместитель директора, заведующий научным отделением диагностической и интервенционной радиологии ФГБУ “НМИЦ онкологии им. Н.Н. Петрова” Минздрава России; профессор кафедры современных методов диагностики и радиолучевой терапии ФГБОУ ВО “Санкт-Петербургский государственный педиатрический медицинский университет” Минздрава России, Санкт-Петербург. 

Sergey S. Bagnenko – Doct. of Sci. (Med.), Deputy Director and Head of the Department of Diagnostic and Interventional Radiology, N.N. Petrov National Medical Research Center of Oncology; Professor of St. Petersburg State Pediatric Medical University, St. Petersburg

https://orcid.org/0000-0002-4714-1228БуровикИ. А.BurovikIlya A.

Буровик Илья Александрович – канд. мед. наук, заведующий отделением лучевой диагностики ФГБУ “НМИЦ онкологии им. Н.Н. Петрова” Минздрава России; ассистент кафедры онкологии медицинского факультета ФГБОУ ВО “Санкт­Петербургский государственный университет”, Санкт-Петербург

Ilya A. Burovik – Cand. of Sci. (Med.), Head of radiology department, N.N. Petrov National Medical Research Center of Oncology; assistant professor in the department of oncology of Saint­Petersburg University, St. Petersburg

https://orcid.org/0000-0002-0940-6491БуськоЕ. А.BuskoEkaterina A.

Бусько Екатерина Александровна – доктор мед. наук, ведущий научный сотрудник научного отделения диагностической и интервенционной радиологии ФГБУ “НМИЦ онкологии им. Н.Н. Петрова” Минздрава России; доцент научно-клинического и образовательного центра “Лучевая диагностика и ядерная медицина” медицинского факультета ФГБОУ ВО “Санкт­Петербургский государственный университет”, Санкт-Петербург

Ekaterina A. Busko – Doct. of Sci. (Med.), breast radiologist, leading researcher in Department of Diagnostic and Interventional Radiology, N.N. Petrov National Medical Research Center of Oncology; associate professor in clinical and educational center “Radiology and Nuclear medicine” of Saint­Petersburg University, St. Petersburg

https://orcid.org/0000-0002-1877-8852ТятьковС. А.TiatkovStanislav A.

Тятьков Станислав Александрович – врач-рентгенолог, специалист магнитно-резонансной томографии отделения лучевой диагностики ФГБУ “НМИЦ онкологии им. Н.Н. Петрова” Минздрава России, Санкт-Петербург

Stanislav A. Tiatkov – M.D. radiologist, MRI-specialist, N.N. Petrov National Medical Research Center of Oncology; Professor of St. Petersburg State Pediatric Medical University, St. Petersburg

https://orcid.org/0000-0003-4665-6999ГришкоП. Ю.GrishkoPavel Yu.

Гришко Павел Юрьевич – канд. мед. наук, научный сотрудник научного отделения диагностической и интервенционной радиологии, доцент отдела учебно-методической работы, врач-рентгенолог отделения лучевой диагностики ФГБУ “НМИЦ онкологии им. Н.Н. Петрова” Минздрава России, Санкт-Петербург

Pavel Yu. Grishko – Cand. of Sci. (Med.), radiologist, researcher, MRI-specialist, N.N. Petrov National Medical Research Center of Oncology; Professor of St. Petersburg State Pediatric Medical University, St. Petersburg

https://orcid.org/0000-0001-6937-2740БерлевИ. В.BerlevIgor V.

Берлев Игорь Викторович – доктор мед. наук, заведующий научным онкологическим и хирургическим отделением гинекологии, врач-онколог ФГБУ “НМИЦ онкологии им. Н.Н. Петрова” Минздрава России; профессор, заведующий кафедрой акушерства и гинекологии ФГБОУ ВО “Северо­Западный государственный медицинский университет имени И.И. Мечникова” Минздрава России, Санкт-Петербург

Igor V. Berlev – Doct. of Sci. (Med.), Head of the scientific oncology and surgical gynecology department, N.N. Petrov National Medical Research Center of Oncology; Professor, Head of the obstetrics and gynecology department, I.I. Mechnikov North­Western State Medical University, St. Petersburg

ФГБУ “ Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова” Минздрава РоссииРоссияN.N. Petrov National Medical Research Center of OncologyRussian FederationФГБУ “ Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова” Минздрава России; ФГБОУ ВО “Санкт-Петербургский государственный педиатрический медицинский университет” Минздрава РоссииRussian FederationN.N. Petrov National Medical Research Center of Oncology; St. Petersburg State Pediatric Medical UniversityRussian FederationФГБУ “ Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова” Минздрава России; ФГБОУ ВО “Санкт­Петербургский государственный университет”Russian FederationN.N. Petrov National Medical Research Center of Oncology; Saint­Petersburg UniversityRussian FederationФГБУ “ Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова” Минздрава России; ФГБОУ ВО “Северо-­Западный государственный медицинский университет имени И.И. Мечникова” Минздрава РоссииRussian FederationN.N. Petrov National Medical Research Center of Oncology; 4 I.I. Mechnikov North­Western State Medical UniversityRussian Federation20241004202428295107Copyright © Павловская Е.А., Багненко С.С., Буровик И.А., Бусько Е.А., Тятьков С.А., Гришко П.Ю., Берлев И.В., 20242024Павловская Е.А., Багненко С.С., Буровик И.А., Бусько Е.А., Тятьков С.А., Гришко П.Ю., Берлев И.В.Pavlovskaya E.A., Bagnenko S.S., Burovik I.A., Busko E.A., Tiatkov S.A., Grishko P.Y., Berlev I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/1408

В обзоре представлены современные данные о безопасности различных методов лучевой диагностики. Основное внимание было сфокусировано на особенностях проведения диагностических исследований беременным женщинам как наиболее уязвимой категории пациентов. Проведен поиск научных статей в информационно-аналитических системах PubMed и Google Scholar за 2003–2023 гг. Большой временной интервал обусловлен тем, что информация о долгосрочных эффектах проведенных диагностических процедур могла быть опубликована в течение длительного времени. Использованные ключевые слова включали: MR-safety, pregnancy, safety during pregnancy, gadolinium, iodinanted contast media, cancer in pregnancy, CT, MRI, US, scintigraphy. Список литературы, включавший сочетания ключевых слов, превышал 2000 источников. Было проанализировано более 100 источников, как иностранных, так и зарубежных, преимущественно рекомендаций, основанных на проведенных исследованиях, а также статей с результатами крупных рандомизированных исследований побочных воздействий лучевых методов обследования на беременную женщину и плод, из которых 63 источника были использованы для составления обзора. Критериями отбора статей являлись: для регламентирующих документов – последняя версия, для клинических исследований – адекватная выборка, отчетливые критерии оценки возможных эффектов и наличие группы сравнения; в случае популяционных исследований – большая выборка и длительный период наблюдения. Проанализированы вопросы безопасности и реальных последствий применения ультразвуковой диагностики, магнитно-резонансной томографии, рентгеновских исследований (в том числе компьютерной томографии), изотопных методов (сцинтиграфии и позитронно-эмиссионной томографии). Изучены существующие методический подходы, направленные на снижение потенциального риска. Представленная информация позволит адекватно оценивать риски методов визуализации и поможет уменьшить обеспокоенность как медицинского персонала, так и пациенток.

The present paper reports available modern data about the safety of medical visualization, including US, MRI, CT, PET and scintigraphy. In all accessed papers, objects are pregnant women and fetuses – the most vulnerable of all groups of patients. We summarize data concerning exposure to radiodiagnostic procedures during pregnancy and approaches to diminish the potential risk. We analyzed articles published between 2003 and 2023 using PubMed and Google Scholar. Keywords included: MR-safety, pregnancy, CT, MRI, US, scintigraphy. The list of found articles consisted of more the 2000 items. We analyzed more than 100 articles in Russian and English and included 63 items in the current review. Primarily we dealt with clinical guidelines based on randomized trials on the safety of radiological methods during pregnancy. Hopefully, presented information, including the latest international recommendations, will help clinicians and patients pursue realistic and informed approaches and minimize anxiety. 

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The authors declare that there are no conflicts of interest present.