The aim of this review is to provide an update on the imaging triage, safety considerations, and cancer-imaging features of common and uncommon gynecological tumors during pregnancy. Clinical examination can be inconclusive, especially for the evaluation of intra-abdominal diseases since symptoms related to cancer such as fatigue, vomiting, or nausea overlap with common pregnancy-associated symptoms. Delayed pregnancy, advanced maternal age, and improvements in diagnostic imaging in developed countries have increased the incidence of cancer diagnosis in gravid populations. Non-invasive diagnostic imaging has a central role in the initial diagnosis and management of pregnancy tumors. Sonography is the first modality for the abdominal evaluation of gravid patients because it is widely available, low cost, and lacks adverse effects on the mother and fetus. MR imaging is considered the imaging modality of choice for diagnosis and staging of gynecologic cancer during pregnancy due to its larger imaging field of view, better reproducibility, and excellent soft tissue contrast. Moreover, whole-body diffusion-weighted imaging (DWI) has been proposed for the oncologic staging of pregnant patients; however, large prospective studies are needed to support its clinical implementation. Gynecological cancer diagnosed during pregnancy requires accurate diagnosis and staging to determine optimal treatment based on gestational age, and therefore multidisciplinary team collaboration is pivotal.
本综述旨在更新妊娠期常见与罕见妇科肿瘤的影像学分流、安全性考量及癌症影像特征。由于癌症相关症状（如疲劳、呕吐或恶心）与妊娠常见症状存在重叠，临床检查可能难以明确诊断，尤其对于腹腔内疾病的评估。延迟生育、高龄产妇以及发达国家诊断影像技术的进步，使得妊娠期癌症诊断率有所上升。无创诊断影像学在妊娠期肿瘤的初步诊断与处理中具有核心作用。超声因其普及性高、成本低且对母胎无不良影响，成为评估妊娠患者腹部情况的首选方法。磁共振成像因其视野范围广、可重复性佳及优异的软组织对比度，被视为妊娠期妇科癌症诊断与分期的优选影像学手段。此外，全身扩散加权成像已被提议用于妊娠患者的肿瘤分期，但其临床应用仍需大规模前瞻性研究予以支持。妊娠期确诊的妇科癌症需通过精确诊断与分期，结合孕周制定最佳治疗方案，因此多学科团队协作至关重要。
Review of the Imaging Modalities in the Gynecological Neoplasms During Pregnancy
肿瘤(癌症)患者之家