Indications for magnetic resonance imaging of the pelvic organs

A study such as magnetic resonance imaging, literally two decades ago, was not an independent diagnostic method. This was just an auxiliary technique. Today, this research method is completely independent, with the help of which it is possible to thoroughly examine not only the anatomy, but also the structure of the tissues of the pelvic organs. The diagnosis is made with great accuracy; at the same time, the cause can be established and the correct treatment can be prescribed in the future.

Principle of the method

MRI of internal organs is based on the use of magnetic waves (not X-rays!), which are used to scan. The waves pass through the tissue, through all departments, and ultimately produce a three-dimensional image. Most often it is multilateral.

It all depends on the number of pictures: the more pictures, the more reliable the information. In some cases, an MRI of the pelvic organs is performed with contrast, which increases the accuracy of the study. What is contrast? This is a substance that is administered intravenously for better visibility of blood vessels.

A gadolinium-based drug is usually used.

Magnetic resonance imaging is significantly different from computed tomography, which uses X-rays to examine the patient. In this regard, it is distinguished by its safety. MRI results are quite accurate.

Indications for the use of MRI of the pelvic organs

• The main purpose of MRI of the pelvic organs is the diagnosis of oncology. The dynamics of the pathology and its degree are identified and monitored.
• Doubts and difficulties in making a diagnosis for pelvic injuries.
• For anomalies and pathologies in the pelvis, this method is used with a certain frequency.
• Magnetic resonance imaging of the pelvis is prescribed for diseases of the kidneys and urinary tract.
• Diagnosis of infertility in men and women helps to establish the cause of the pathology, as shown by MRI of the pelvis in women and MRI of the pelvic organs in men.
• For congenital anomalies of the rectum.
• Before and after surgery in the pelvis.
• To find out an accurate diagnosis when other studies have not yielded results.

In cases where it is necessary to determine the area of ​​spread of metastases, MRI with contrast is used.

This method allows you to see not only the affected areas, but also the organs adjacent to them.

MRI with contrast

MRI with contrast is enhanced. This allows us to obtain information about the structure of oncological education. It can be used to monitor the effectiveness of radiation and chemotherapy.

A pelvic examination with contrast provides a complete visual picture of the condition of the lymph nodes in the pelvis. Examination of organs using this method makes it possible to identify pathology in its initial stage.

MRI in women

Female pelvic organs

The use of MRI of the pelvic organs in women allows us to identify pathologies of the female organs (uterus, vagina, ovaries), as well as the bladder and lymphatic system. With its help, we can suggest the cause of the main female diseases:

1. Determine the cause of menstrual irregularities;
2. Diagnose endometriosis;
3. Identify inflammatory processes in the pelvic organs both in the initial stage and in the chronic form;
4. Identify fibroids, polyps, cysts;
5. Assess the condition of the fallopian tubes, detect the adhesive process;
6. Identify defects in ovarian development and determine their position.

For certain indications, MRI can be performed on pregnant women. The only exception is the early stages of pregnancy.

MRI in men

Male pelvic organs

A man is prescribed a magnetic resonance examination for the following diseases:

1. Prostatitis and vesiculitis;
2. Injuries to the male genital organs;
3. Vascular disorders of the male pelvis;
4. To identify neoplasms;
5. Other pelvic pathology;
6. To clarify the data that was obtained using alternative diagnostic methods.

For MRI of the pelvis in men, indications are also required.

Contraindications

MRI has no analogues, because the method is practically safe. But it also has contraindications. What does this mean?

Absolute contraindications

• The presence of implants that contain metal particles: dental crowns, shunts, clips, pacemakers, insulin pumps, etc.;
• In cases where MRI is performed with contrast, a contraindication is the presence of an allergy to the contrast agent;
• Tomography with a contrast agent is not used even if the patient has renal failure. The contrast agent is excreted by the kidneys, which can cause exacerbation of the disease;

Relative contraindications

Such contraindications for which this examination is not recommended, but can be carried out in case of urgent need:

• Pregnancy. If there is a threat to the mother's life, diagnosis using this method is possible. In this case, tomography without contrast is acceptable;
• Breast-feeding. If necessary, stop breastfeeding;
• If the patient has claustrophobia, the examination is either not carried out or measures are taken to ensure complete immobility. Such a measure could be medicated sleep;
• Children under 5 years old, because small children cannot be required to be completely immobile;
• Overweight, more than 130 kg, as well as a large waist circumference. This is due to the size of the rather narrow tomograph chamber. However, currently there are open-type tomographs, the use of which is possible for overweight people.

Side effects during magnetic resonance imaging of the pelvic organs are extremely rare. They may be caused by a reaction to the contrast agent. Manifest in the form of burning, urticaria, itching. Coughing and shortness of breath may occur.

MRI flow chart

1. Before an MRI, the doctor must identify the absence of all possible contraindications and explain how the examination is performed.
2. The patient is explained all the nuances of diagnostics, how an MRI is done, and sometimes they are asked to change clothes for the scan.
3. Immediately before scanning, you should remove all metal-containing objects from yourself.

   Their presence is unacceptable on MRI.

4. The patient lies down on the machine table, taking a more comfortable position. After which it is secured with straps and bolsters to ensure complete immobility.
5. The table slides into the tomograph.

   In some cases, sound-proof headphones are worn (as the loud sound of the tomograph may cause discomfort in some patients).

6. There is a microphone installed in the tunnel of the device, which can be used to communicate with a doctor.
7. If the diagnosis is carried out with a contrast agent, then sensations of cold or heat may appear.

8. The contrast agent is administered automatically through a catheter, which is previously installed intravenously.
9. The diagnostic time lasts about half an hour. If the study is carried out using contrast, it can double in size.
10. And the last stage is deciphering the result.

    It takes about 1 - 2 hours (sometimes due to the need for more detailed analysis, results may be provided the next day). The transcript of the pelvic MRI is given to the patient.

Preparation for the procedure

Before the examination, preparation for MRI of the pelvic organs is necessary. What does it include? Be sure to prescribe a diet that reduces gas formation, i.e. you need to exclude gas-forming foods (legumes, carbonated water, dairy products, etc.) from your diet. These days you need to drink plenty of fluids. But 4-6 hours before the examination you will have to refuse liquids.

Directly on the day of the study, 1 hour before it, it is recommended to take an antispasmodic (no-spa, papaverine, drotaverine). If the tomography is performed without contrast, then in the morning you can afford a light breakfast. If contrast is performed only on an empty stomach, eating is not allowed.

In addition to the general rules for preparing for an examination, compliance with specific measures is required, which directly depend on the type and purpose of the examination:

• Bladder diagnosis requires that the bladder be full; In all other cases, on the contrary,
• When diagnosing diseases of the rectum, the intestines must be emptied. If this cannot be achieved naturally, then an enema must be done.

Preparation for MRI of the pelvis in men is not limited by time. Examination of women with pathologies of the uterus, ovaries and fallopian tubes. The examination is usually carried out in the second week of the menstrual cycle.

When a doctor prescribes this examination, the patient must be explained how to prepare for an MRI of the pelvis.

MRI in relation to other alternative methods

The conclusions obtained after magnetic resonance imaging are significantly superior to those obtained by alternative methods: ultrasound, computed tomography and radiography. What could not be determined using traditional methods will be revealed by MRI.

With this diagnosis, it is possible to study with “full immersion” into the pathological area, which makes it possible to identify even minor changes in tissues and organs. It provides more complete information and allows inspection in all planes.

MRI is a non-invasive procedure, meaning one that does not require surgery.

In conclusion, I would like to say once again that preparation for the study plays a big role in diagnosis, otherwise the result may be somewhat distorted. The patient must know how such an examination is carried out.

Magnetic tomography can be performed repeatedly and at short intervals. This does not pose any danger.

That is why the method of magnetic resonance imaging has become independent and one of a kind.

Using MRI to diagnose diseases of the pelvic organs Link to main publication

Source: https://CheckUpAdviser.ru/mrt-scan/malyiy-taz/mrt-malogo-taza

Magnetic resonance imaging (MRI) of the pelvic organs

Magnetic resonance imaging (MRI) is a modern non-invasive and highly informative method for visual examination of internal organs. This method is based on the biological phenomenon of human body cells emitting impulses in response to exposure to a high-power magnetic field.

Thanks to this method, it became possible to study even the smallest structures in the thickness of tissues, study their organic and functional characteristics, and assess the degree of their deviation from the norm.

Using MRI of the pelvis, you can examine those organs that are inaccessible to other types of research, since they are reliably protected by a powerful bone, muscle and connective tissue framework. It is often prescribed as a clarifying research method or for non-operative differential diagnosis.

The essence of the method

Diagnostics is based on the phenomenon of nuclear magnetic resonance. Under a powerful magnetic field, hydrogen protons in the molecules of living cells begin to absorb electromagnetic energy.

The echo signal from them is captured by highly sensitive Fournier sensors, and with the help of a computer it is converted into an anatomical photograph (section) of tissues and organs, depending on the intensity of the received signals.

MRI of the pelvic organs is carried out in several successive stages. The first of these is a survey image of the pelvis, with the help of which general points are clarified: the presence or absence of organs, their general condition, localization and relative position in the pelvis. Next, slices are obtained in different modes, pulse sequences and projections.

Indications for use

The female pelvis contains the internal genital organs (uterus with appendages, cervix, vagina), bladder and rectum, while the male pelvis contains the bladder, seminal glands, prostate gland and rectum. Considering that men and women have different organs located in the pelvis, the indications for MRI are also different.

Common indications for pelvic MRI for men and women are:

• pain in the pelvic organs of unknown etiology (usually prescribed after ultrasound);
• inflammatory processes in this area (infiltrates, abscesses);
• diseases of the bladder and lower ureters;
• benign or malignant neoplasms in the pelvis (cysts, tumors);
• metastases to the pelvic organs;
• developmental anomalies;
• prolapse of internal organs;
• rectal diseases.

MRI of the female pelvis allows you to evaluate the condition of the bladder, uterus, fallopian tubes, ovaries, vagina, peri-uterine and peri-vaginal space, and lower intestines. Thus, the indications for its implementation in women (as opposed to men) are:

• bleeding from the internal genital organs of unknown origin;
• detection of a tumor or other neoplasm in the genital organs using other examination methods;
• endometriosis;
• infertility;
• adhesive disease.

In this case, a planned examination of the internal genital organs of menstruating women (uterus, fallopian tubes, ovaries) is carried out on days when there is no menstruation.

The study in men is carried out to evaluate the condition of the prostate gland and vas deferens, bladder and rectum.

Taking into account the wide range of indications, medical specialists of various profiles can refer for the procedure of magnetic resonance imaging of the pelvic organs: gynecologist, urologist, andrologist, proctologist, surgeon, traumatologist, oncologist.

Contraindications to the procedure

Despite the fact that MRI is a safe and painless procedure, it still has a number of contraindications. They mainly concern the features of the methodology. The device creates a strong magnetic field, so this study is strictly prohibited for persons with:

• cochlear implants;
• metal stents, clips or staples (for example, on blood vessels);
• artificial valves in the heart;
• implanted neuro-, pacemakers or defibrillators;
• shrapnel, bullets or other metal objects in the body.

Magnetic resonance imaging is not recommended for women in the first trimester of pregnancy. There is no reliable data on the harm of a magnetic field for a baby, but the risks of pathologies occurring during this period are so high that it is better to temporarily abandon such an examination in favor of other methods, for example, ultrasound diagnostics.

Advantages and disadvantages of the technique

The magnetic resonance imaging method has many advantages over other diagnostic studies:

1. It is non-invasive, that is, it does not injure tissue and does not cause pain in the patient.
2. The study is very informative, therefore it allows you to identify pathology in the early stages of its development.
3. The high resolution of the procedure allows you to obtain clear and very thin sections, which is important when studying oncological processes in the body.
4. There are no invisible zones in the resulting images, as with ultrasound.
5. Sections can be obtained in any plane, which shows the exact relationship of the pathologically changed organ with neighboring tissues.
6. The contrast agent used (if necessary) gives much fewer side effects and allergic reactions than iodine-containing contrast used in x-ray examination methods.
7. The absence of radiation exposure to the patient makes it possible to re-examine the patient during treatment without harm to him.

The disadvantages of the magnetic resonance imaging method include the impossibility of performing it in those patients who have permanent metal-containing objects in their bodies. It is difficult to perform MRI on small children: during the procedure it is necessary for the patient to lie still, and children cannot lie without moving.

Another disadvantage of the magnetic resonance method is the high price for the procedure (from 5 thousand rubles and above).

Preparing for the study

In an emergency, MRI can be performed without prior preparation. To avoid artifacts in the images or unwanted side effects, you need to properly prepare for the planned procedure. The doctor sending him for examination should inform the patient about the preparation rules. Preparation for the study does not involve any complex procedures.

2-3 days before the procedure, it is recommended to adhere to a diet: exclude fatty, fried foods, legumes, cabbage, and carbonated drinks. It is better to eat liquid or semi-liquid food, which is quickly eliminated from the body and does not provoke increased gas formation in the intestines. It is better for the patient not to eat 4-6 hours before the test.

On the eve of the study, it is advisable to cleanse the intestines. To do this, you can give a cleansing enema in the evening or take laxatives in the last 1-2 days before the MRI. An empty intestine will not interfere with the examination of the uterus and its appendages, and will also allow visualization of the condition of the intestinal wall itself if oncology, metastasis or germination of endometriosis is suspected.

The bladder should be full - do not urinate an hour before the test and drink 2 glasses of water immediately before the test. Sufficient filling of the bladder provides good visualization of the bladder walls, but an overfilled bladder should be avoided as this increases the likelihood of artifacts on the images. When the bubble is full, image clarity decreases.

For MRI contrast, substances containing gadolinium salts are used. If an examination using a contrast agent is planned, the examinee must warn the medical staff of the MRI diagnostic room about the presence of kidney pathologies, allergies or bronchial asthma.

Immediately before the procedure, patients must remove clothing with metal fittings: belts, watches, hearing aids, removable dentures, jewelry and costume jewelry (rings, chains, earrings, cufflinks, body piercings), remove credit cards, knives from pockets, glasses, mobile phones, that is, anything that contains any metal. The subject's clothing should not be tight or tight.

Examination technique

A properly prepared patient changes into disposable clothing or wears his own clothing without metal fittings. After this, he lies down on a special couch, which will move along the scanning tube. There are closed and open type devices.

A closed-type tomograph is a cylinder, into the walls of which a powerful magnet and special sensors are mounted that capture signals. The couch with the patient moves along this cylinder.

This type of device is not suitable for patients with a fear of closed spaces (claustrophobia) and for persons with severe obesity (more than 120 kg). Closed-type tomographs are considered more preferable for research because they provide a clearer and higher-quality image.

In open-type tomographs, the magnet and sensors are mounted in a hemisphere, which is located above the patient, and such a device is open on the sides.

In pelvic MRI, a magnetic coil is placed opposite the patient's pelvis. During the procedure (without contrast - 20-30 minutes), the subject must lie still. Any movement can distort the result of the study.

The tomography itself is an absolutely painless procedure, but if the patient experiences pain even before it begins, he must be given painkillers, antispasmodics or sedatives. During the examination, a person hears a crackling sound in the device and may feel warmth in the body.

A microphone and a speaker are built into the device, and the process is constantly monitored by the x-ray technician performing the examination and the radiologist, so at any time the patient can inform the medical staff if he has any doubts about his well-being.

Side effects

Side effects during MRI examinations are extremely rare.

One rare but dangerous side effect is systemic nephrogenic fibrosis, which can occur in patients with severe kidney disease during contrast-enhanced procedures.

The drug is excreted in the urine, so contrast can only be performed on patients without severe renal pathologies. Allergic reactions to the contrast agent can also develop if the patient is individually intolerant to it.

After receiving the MRI diagnostic report, the patient must contact his or her physician.

To make a diagnosis, magnetic resonance imaging alone is not enough: it is necessary to take into account the history, complaints, features of the clinical course, results of laboratory tests and instrumental methods.

All these data should be assessed in combination: only in this case can the likelihood of making an erroneous diagnosis and, accordingly, prescribing the wrong treatment be minimized.

Author of the article:

Tedeeva Madina Elkanovna

Specialty: therapist, radiologist.

Total experience: 20 years.

Place of work: SL Medical Group LLC, Maykop.

Education: 1990-1996, North Ossetian State Medical Academy.

Training:

1. In 2016, at the Russian Medical Academy of Postgraduate Education, she underwent advanced training in the additional professional program “Therapy” and was admitted to carry out medical or pharmaceutical activities in the specialty of therapy.

2. In 2017, by the decision of the examination commission at the private institution of additional professional education “Institute for Advanced Training of Medical Personnel”, she was admitted to carry out medical or pharmaceutical activities in the specialty of radiology.

Work experience: therapist – 18 years, radiologist – 2 years.

Source: https://FoodandHealth.ru/diagnostika/mrt-organov-malogo-taza/

Rules for conducting pelvic MRI in women

Magnetic resonance imaging, or MRI, in recent decades has evolved from a method with uncertain indications for its use into an entire independent section of medical radiology, allowing for the objectification of the diagnosis of many diseases.

MRI of the internal organs of the pelvis makes it possible to accurately determine the anatomical relationship and condition of the genitourinary organs, identify the pathological process, its localization and nature, as well as its relationship to neighboring organs, which greatly facilitates diagnosis and the correct choice of treatment tactics, especially in terms of landmarks during endoscopic operations.

Possibilities of MRI of the pelvic organs in women

The main conditions that apply to various diagnostic methods used in obstetrics and gynecology are safety, non-invasive or minimally invasive methods, a high degree of information content and the absence of radiation exposure. The latter makes it possible to carry out further dynamic monitoring of the effectiveness of the therapy.

The pelvic MRI method in women fully meets all of these listed requirements. Its main advantage is that in one study this diagnostic method combines some of the best characteristics of both X-ray computed tomography (X-ray computed tomography) and ultrasound (US).

MRI, like X-ray CT, makes it possible to obtain detailed information and detect changes not only in the pelvic organs - the uterus, appendages, sigmoid colon, rectum, bladder with ureters, but also in the soft tissues of the pelvic area, its walls, peritoneum and lymph nodes. However, in this case, radiation exposure to the body is completely excluded, which allows for repeated studies to determine the immediate and long-term results of conservative or surgical treatment.

When choosing a diagnostic method, which is better, MRI or pelvic ultrasound? In obstetrics and gynecology, ultrasound remains the main method for the primary detection of disorders, while the results of MRI allow us to clarify and complete the diagnostic stage. The advantages of the method are that:

• Compared to transabdominal ultrasound, the picture of direct MRI images of the pelvic organs in several planes is not limited to narrow echographic “windows”;
• in comparison with transvaginal ultrasound examination - it surpasses it in the volume of data obtained, clarity and reliability of information;
• there are no restrictions in conducting studies of the pelvic organs in girls, while this factor significantly reduces the possibilities of echography;
• there is no need for maximum filling of the bladder, which is of great importance in cases of impaired tone, urinary incontinence, etc.;
• this method is much more effective both in diagnosis and in dynamic monitoring in the treatment of patients with incompetence of the pelvic floor muscles, especially with complications such as urinary incontinence and some others.

In cases of suspected cancer, MRI of the pelvic organs allows:

1. Determine definitively and with high confidence the absence or presence of a tumor formation.
2. Determine the size, contours and internal structure of the neoplasm (the presence of cysts, tissue necrosis, hemorrhages).
3. Identify the organ from which it originates or with which it is connected, the anatomical position of the tumor in relation to other organs.
4. Carry out a volumetric review of the pelvic organs and identify the presence of ascitic fluid, as well as enlarged lymph nodes, which may have metastasized.
5. Find out about the possibility of performing a puncture or other type of biopsy of a formation that is “suspicious” of a malignant tumor.

Are adhesions visible on MRI? Despite the high information content of the method, a conclusion about the adhesive process in the pelvis can be made only by indirect signs, although more reliably than with ultrasound.

Only very coarse adhesions can be seen in the resulting images. It is generally impossible to judge their presence in the lumen of the fallopian tubes or in the area of ​​the villi of the funnel of the tube.

In these cases, hydrosalpingography and laparoscopic diagnosis are mainly used.

General idea of ​​the principle of the method

What is the research being done on? The method is based on the phenomenon of nuclear magnetic resonance. For this purpose, there are various magnetic resonance imaging scanners that generate radio frequency pulses that are directed to the area under study. These radio frequency waves create a uniform, specially configured high-intensity electromagnetic field.

The MRI procedure itself, both of the pelvic organs and other organs, consists of placing the patient in a horizontal position on a movable table in a special tomograph chamber, which contains several magnetic coils of the device. Through the latter, the required zone is scanned.

These devices are designed for specific areas of the body. They can be closed or open. In the latter, the coil is placed only over the area under study. Therefore, they are more comfortable for patients, especially for those suffering from claustrophobia, but their power is almost half as powerful. How long does the scan take? The duration of the procedure is from 20 to 40 minutes.

The principle of obtaining images is as follows. Many protons in the human body, which are the nucleus of the hydrogen atom, constantly rotate around their natural axis.

Under the influence of the powerful magnetic field created by the device, they line up in a certain way and rotate around a new axis.

After the impact on the area under study ceases, the nuclei return to their original state, releasing energy, which is perceived by the coil and then processed by a computer program.

The denser the tissue or liquid, the more energy it emits. In addition, the amount of energy depends on the duration of the alignment of hydrogen atoms. It is greater in softer tissues compared to dense ones. The computer, receiving information about different energies, builds corresponding images of different areas.

Some patients are prescribed a pelvic MRI with contrast - what is it? The study involves the intravenous administration of special extracellular low-molecular substances based on the chemical element gadolinium - Omniscan, Magnevist.

These drugs have pronounced paramagnetic properties - absorption and emission of electromagnetic waves in the radio frequency range.

They extremely rarely cause allergic reactions and do not lead to anaphylaxis, unlike iodine radiocontrast drugs.

After being introduced into the blood under the influence of an electromagnetic field, the contrasting solution accumulates and is distributed in the tissues of the area to which this field is directed, which makes it possible to obtain a significantly larger amount of information.

Indications and contraindications for the study

How often can an MRI be done? There is no data on the harmful effects of the procedure on patients. Therefore, there are no regulations regarding the frequency of studies, as well as the duration of their conduct.

It all depends on the need for primary diagnosis or dynamic monitoring of treatment results and is determined by the treating specialist.

At the same time, as with other studies, it is necessary to take into account the presence of contraindications in patients:

1. The first trimester of pregnancy, during which all organs of the fetus are formed.
2. The presence of implanted systems for dosed administration of drugs or an artificial heart pacemaker, since a powerful electromagnetic field can disrupt their functioning.
3. The presence of auditory implants or vascular stents, metal joint endoprostheses or pins, plates, bolts, staples, screws installed for the purpose of repositioning and holding bones in the fracture area.
4. Claustrophobia (fear of closed spaces). This contraindication is taken into account only when using closed-type devices.

After the study, the specialist interprets the MRI, which can describe the anatomical changes of the uterus and appendages, deviations from their physiological position in the pelvis or in relation to each other, inflammatory changes in tissues, the presence of endometriosis indicating the stage of its development, the presence of fluid in Douglas space (behind the uterus), indirect signs of adhesions in the pelvis. Tumors and tumor-like formations, their sizes and connections with other organs, the presence of metastases in the pelvic bones and regional lymph nodes are also described in detail.

It is also possible to detect polyps in the bladder, pathological pathological changes in the bladder and lower parts of the large intestine, etc. After this, the results of the study and its interpretation are formalized into a presumptive or final conclusion.

Indications for MRI of the pelvic organs in women

How often can an MRI be done? There is no data on the harmful effects of the procedure on patients. Therefore, there are no regulations regarding the frequency of studies, as well as the duration of their conduct.

It all depends on the need for primary diagnosis or dynamic monitoring of treatment results and is determined by the treating specialist.

At the same time, as with other studies, it is necessary to take into account the presence of contraindications in patients:

1. Cases of difficulty in making a final diagnosis after all non-invasive clinical laboratory and traditional instrumental studies, including ultrasound, colonoscopy and others.
2. Contradictions between the symptoms of the disease and the results of the examination already carried out using the above methods.
3. Assumption of the presence of common forms of endometriosis and endometrioid ovarian cysts.
4. Assumption of the presence of adhesions in the pelvis in patients operated on for endometriosis.
5. The presence of tumors in the pelvis to resolve the issue of the possibility of surgical intervention using laparoscopic methods.
6. Clarification of the nature of developmental anomalies of the urinary or reproductive system.

Contrast-enhanced MRI shows:

• in cases of difficulty in making a diagnosis and difficulty in carrying out differential diagnosis based on data obtained as a result of conventional magnetic resonance scanning;
• if it is impossible to carry out the necessary tomographic “slice” in order to delimit the tumor from the tissues surrounding it, determine the exact boundaries and number of foci, which makes it possible to determine the volume of surgical intervention, if necessary;
• if it is necessary to fully assess the structure of a tumor or other formation;
• for better visualization of regional lymph nodes;
• in order to monitor the sufficiency of surgical treatment, the effectiveness of chemotherapy and/or radiation therapy.

Preparation for MRI of the pelvic organs in women

The examination is carried out with a slightly or moderately full bladder. If emergency diagnostics are required, special preparation for MRI is not carried out. How to prepare for a planned study?

For these purposes it is recommended:

• maintain proper nutrition several days (2-3) before the procedure; The recommended diet before MRI involves excluding foods that can increase intestinal motility and the formation of gases in it (foods rich in fiber, legumes, animal fats, fatty meats, carbonated drinks, flour products);
• taking laxatives on the eve of the procedure, followed by a cleansing enema before bedtime and in the morning on the day of the examination;
• taking antispasmodic drugs (No-spa) the day before and half an hour to an hour before the procedure (in the presence of spastic abdominal pain);
• conducting the study on an empty stomach.

On what day of the cycle is an MRI performed? It is advisable to carry out the examination from 6 to 14 days of the cycle, counting from the first day of menstruation, but it is also possible during the second phase of the menstrual cycle.

The main disadvantages of magnetic resonance imaging are the duration of the procedure session, the inability to reliably diagnose stones and calcifications, the inability to examine patients with an artificial heart pacemaker and the presence of metal structures in the body, and the rather high cost of the equipment and its operation.

Source: https://ginekolog-i-ya.ru/mrt-malogo-taza-u-zhenshhin.html

MRI of the pelvic organs

• Magnetic resonance imaging (MRI) is an effective non-invasive (performed without surgery) diagnostic method that allows a detailed examination of the organs and tissues of the pelvis.
• Based on MRI results, the doctor can determine the presence, cause, and extent of spread of diseases of the internal pelvic organs at different stages of development, make an accurate diagnosis and prescribe adequate treatment.
• For women, MRI is prescribed to examine the uterus, vagina, ovaries, fallopian tubes, bladder and all tissues of the pelvis.
• In men, the seminal vesicles, vas deferens, prostate gland, bladder, ureters and rectum are examined.

MRI of the pelvic organs with contrast is performed strictly according to indications, most often to detect oncology and various infectious diseases.

It is in these pathologies that the “sick” areas of tissue are especially intensively nourished through an extensive network of small blood vessels, which is clearly visible in MRI images with contrast.

Indications

An MRI of the pelvic organs is prescribed by an oncologist, gynecologist, surgeon, urologist or proctologist. There are no age restrictions for this study.

Main general indications:

• diagnosis of cancer, detection of metastases;
• injuries and developmental abnormalities;
• pain for a long time in the sacrum and pelvis;
• cyst rupture or suspicion of this condition, other acute surgical pathologies;
• diseases of the urinary system (stones and sand in the ureters, etc.);
• infertility;
• pathological processes in the rectum.
• damage, defects and pain in the hip.

1. Indications for MRI in women:
2. For men:
3. Also, MRI of the pelvic organs is prescribed to clarify the results of other diagnostic examinations, in the preoperative period and to monitor the patient’s condition after surgical treatment.

Contraindications

As with any medical examination, there are a number of contraindications for MRI of the pelvic organs.

Absolute contraindications that make the procedure impossible include the following:

• implants and other foreign bodies containing metal (the only exception is implants in the oral cavity);
• implanted electronic devices (pacemakers, insulin pumps, etc.);
• installed Ilizarov apparatus (a system that fixes bone fragments in the correct position for complex bone fractures);
• allergy to contrast agent;
• chronic renal failure (with MRI with contrast, the substance is excreted from the body through the kidneys and can provoke an exacerbation of the disease);
• the patient is overweight (more than 130 kg) and waist circumference exceeds the diameter of the MR capsule.

A variety of implants and endoprostheses containing metal can affect the accuracy of the data obtained and distort the picture of the condition of the internal organs. And the magnetic field of the tomograph can disrupt the uninterrupted operation of life-supporting electronic devices (heart pacemaker, for example). Therefore, patients with such devices are prohibited from undergoing MRI.

There are contraindications for MRI, which do not prevent the procedure, but somewhat limit it. These include:

• Early pregnancy. MRI is not recommended for pregnant women under 20 weeks. However, in case of urgent vital need, the examination is considered acceptable.
• Lactation period (breastfeeding). The contrast agent passes into breast milk, so nursing mothers are advised to wean their baby off the breast for 2 days. Milk must be expressed and never given to the baby.
• Claustrophobia (fear of closed spaces) and hyperkinesis (a disease of the nervous system accompanied by increased motor tone). Patients with these diseases or a tendency to them will not be able to remain calm and completely still during the study. If an MRI is performed for emergency reasons, then the subject is put into medicated sleep for the duration of the procedure.
• Children's age up to 5 years. Although the procedure has no age restrictions, young patients are not always able to remain completely still for the required time. And if it is not possible to avoid the examination, it is recommended that the child be given a mild sedative before the procedure.

Preparing for an MRI of the pelvis

The specifics of preparatory measures for MRI of the pelvic organs depend on the purpose of the study.

• For 2 days before the procedure, you must adhere to a diet that excludes foods that can cause increased gas formation in the intestines (vegetables, fruits, legumes, carbonated drinks).
• On the day of the study, 1 hour before the MRI, it is recommended to take any antispasmodic (no-spa, drotaverine, papaverine).

Important! MRI with contrast is performed strictly on an empty stomach. For a procedure without contrast, a light breakfast is allowed.

• With MRI of the bladder, it is important not to urinate before the examination, as the bladder must be full (for better visualization);
• When examining other organs, on the contrary, it is advisable to empty the bladder in order to obtain the highest quality images;
• Before MRI of the rectum, it is necessary to empty the intestines (if the patient suffers from constipation, then a cleansing enema must be done);
• For women with gynecological diseases, MRI of the ovaries, uterus and fallopian tubes is performed in the 2nd week of the menstrual cycle (from 6 to 9 days).

What does an MRI of the pelvic organs show?

The test result is usually prepared within 1-2 hours after the procedure and given to the patient.

In women, examination may reveal:

• cancer (ovarian, cervical and others);
• endometriosis and uterine fibroids;
• neoplasms and various pathologies in the ovaries and fallopian tubes.

In men, diagnostics can detect cancer of the testicles, bladder and prostate gland.

In addition, pelvic MRI can detect birth defects, bone tumors, arthrosis, and hip fractures.

Technique

Before starting the diagnosis, the radiologist conducts a survey of the patient to identify allergic reactions, the presence of metal implants in the body or tattoos with metal-containing inks.

For women, it is determined whether they are pregnant or whether she is a nursing mother. All this is necessary to once again make sure that the patient has no contraindications to the examination. During the conversation, the patient is explained the tactics of his behavior in case of unforeseen situations (panic, fear) and/or if his health worsens.

The subject changes into cotton clothes, removes all jewelry, wristwatches, hairpins and other metal objects.

The table, together with the patient, slides into the tunnel of the tomograph (a large round magnet).

In the shooting mode, the tomograph produces characteristic sounds (clicks, hums), which the patient may not hear if he used the headphones suggested by the nurse. But the patient can judge that the device is working by a feeling of burning in the pelvic area and an increase in local temperature. There is no need to be afraid, this is how the magnetic field and high-frequency impulses affect the body.

If it is necessary to administer a contrast agent before the procedure, the nurse will place an intravenous catheter. During the procedure, the product is injected automatically. Its entry into the vein is accompanied by a feeling of heat or cold spreading through the bloodstream.  

An MRI of the pelvic organs takes 30-45 minutes. An MRI scan with contrast may take a little longer.

Side effects

MRI does not harm human health. However, in some cases (about 1-2%), manifestations of increased sensitivity to the contrast agent may be observed: symptoms of urticaria, itching and burning in the area where the catheter is installed, bronchopulmonary symptoms (heaviness in the chest, difficulty breathing, sometimes suffocation, cough) and other reactions.

More often, this reaction occurs in people who hid from the doctor or did not warn him due to their ignorance about their tendency to allergies.

Alternative diagnostic methods

Compared with ultrasound (US), radiography and computed tomography (CT), magnetic resonance imaging has undeniable advantages. This

• “full immersion” in the area under study;
• the ability to examine organs and tissues in all planes;
• high contrast and better resolution;
• the ability to detect even minor changes in organs and tissues;
• higher information content in terms of diagnosing benign tumors, cancer and infections.

Such a volume of information as an MRI can only be provided by hysteroscopy - an endoscopic examination of the internal organs and tissues of the pelvis using special surgical equipment.

MRI is a non-invasive (non-traumatic) procedure, making it the most popular diagnostic method.

In addition, the safety of the procedure makes it possible to repeatedly examine one patient at relatively short intervals.

Source: https://www.diagnos.ru/procedures/manipulation/mrt/mrt-taz

MRI of the pelvic organs

We use highly effective diagnostic devices that have proven themselves in clinics in Germany, Italy and the USA.

We'll call you back and make an appointment within 20 minutes

24/7

Same-day examination without queues

30% discount on examinations at night

MRI is the most informative method for studying the pelvic organs, used in the diagnosis of diseases of the bladder, rectum and reproductive organs. Provides multi-planar and three-dimensional visualization of anatomy in normal and pathological conditions, it.

Patients undergoing magnetic resonance imaging are not exposed to ionizing radiation (X-rays) or iodinated contrast agents, making this examination safe for children. 

What does an MRI of the pelvic organs show?

Often, a classic physical examination is not enough to assess the causes of pelvic floor dysfunction. MRI scanning allows you to obtain images with contrast of both bone and soft tissues and makes it possible to assess the degree of development, size and exact localization of infectious, inflammatory and tumor processes.  

Magnetic resonance imaging of the pelvic organs allows you to study the anatomy of the bladder and urinary ducts, lower intestines, muscles, organs of the reproductive system, and also identify the cause of female or male infertility. The information obtained during the scan is used by doctors when making a diagnosis and planning drug or surgical treatment strategies.  

An MRI of the pelvis may reveal:

• Inflammatory diseases of the pelvic organs;
• cysts, benign and malignant tumor formations, fistulas, abscesses;
• adhesions in the fallopian tubes in women.

Because the pelvic area contains your reproductive organs, your doctor may order the test for a variety of reasons, depending on your gender.

MRI scanning of the pelvic organs is prescribed to people, regardless of gender, when:

• Injuries in the pelvic area;
• pain in the lower abdomen or pelvis;
• difficulty urinating and/or defecating;
• suspected benign or malignant neoplasms in the reproductive organs, bladder, rectum or urinary tract;
• suspected infections or inflammatory diseases;
• suspected aseptic / avascular necrosis of the thigh;
• dysfunction of the sacroiliac joint.

For women, the doctor may prescribe a pelvic tomography to diagnose the following pathologies:

• Infertility;
• irregular vaginal bleeding;
• masses in the area of ​​the uterus and appendages (for example, fibroids), congenital anomalies;
• assessment of the general condition of the uterus before surgery, embolization;
• fetal examination.

For men, MRI of the pelvis is prescribed in the following cases:

• Cryptorchidism (undescended testicle);
• prostate cancer;
• lumps in the scrotum or testicles, swelling in this area.

The MRI machine creates a strong magnetic field: the presence of any metal object in the examination area (pacemaker, metal prosthesis or clip) can affect the quality of the images, cause you discomfort or injury during the magnetic resonance imaging scan.

In a situation where it is preferable to perform MRI with contrast, limitations on the applicability of the method are imposed by the presence of a history of kidney or liver disease, or an allergy to the contrast agent. 

If the diagnosis does not require the administration of contrast, there is no need to prepare for it in advance. Immediately before starting the tomograph, it is important to remove all metal jewelry, buckles and electronic devices: the center administrators will help you with this.

Before a tomography with contrast, it is advisable not to eat for 2-3 hours and drink only water.

How is an MRI performed and how long does it take?

The procedure is completely painless, does not cause any discomfort and usually takes from 20 to 50 minutes, depending on which areas of the body are examined and how many images need to be obtained. It is important that you relax and lie as still as possible: any movement during the examination will blur the resulting image. MRI results will be ready within an hour.

The high-field tomographs GE Signa HDxt 1.5 T from the CMRT clinic are excellent for MRI diagnostics.

The equipment is distinguished by the accuracy of the results and the speed of the procedure, and is used both in the diagnosis of oncological diseases and localization of metastases, and for procedures that require less resolution. 

Sign up for a CMR clinic

Call +7 495 181-96-05 or leave your details, we will call you back and answer all your questions

Consultation with a doctor before MRI is free

30% discount on examinations at night

Examination on the day of treatment

Saint Petersburg

• Chernyshevskaya
• Narvskaya
• Ozerki Vyborgskoe highway, 40
  • +7 812 640-36-03
  • 10:00–21:00 seven days a week
  • You can leave your car in a parking lot near the center. Or near house 48, 200 meters from the center

• Ladoga

• Petrogradskaya

• Moscow

• Old village

Leningrad region.

• Kolpino Blvd. Workers, 18, bldg. 1 8:00–22:00 seven days a week The car can be left on Workers Boulevard or in the courtyard of house 22
• Kingisepp st. Vorovskogo, 20 Mon, Wed, Fri, Sat, Sun — 9:00–22:00 Tue, Thu — 7:00–00:00 You can leave your car in the parking lot near the center
• Vyborg st. Kuibysheva, 10 8:00–22:00 seven days a week The car can be left near the center on Kuibysheva Street. Or on Ilyinskaya and Akulova streets

Early diagnosis allows you to promptly identify hidden diseases and prescribe preventive treatment, preventing the appearance of severe symptoms in the future. We use modern high-precision methods that are safe for the body.

Source: https://cmrt.ru/diagnostika/mrt-magnitno-rezonansnaya-tomografiya/mrt-organov-malogo-taza/

Contraindications to MRI of the pelvic organs

MRI is considered a safe imaging technique. Unlike CT, ionizing radiation is not used.

When used correctly in modern medical practice, electromagnetic fields do not interact with the body's tissues in such a way as to cause permanent changes in them.

However, careless handling and mistakes made when performing the research procedure can cause harm to the health of the patient, staff, and also damage the device itself.

General contraindications for MRI examination of the pelvis:

— patients with electronic medical devices (heart pacemaker, neurostimulators, etc.). Patients who have ferromagnetic implants should not enter the MRI room.

- you need to remove all metal objects (keys, coins, paper clips, hair clips, ballpoint pens with a spring mechanism), put out devices with electric batteries (cell phone).

- pregnancy first trimester. The study is possible only for vital indications.

• - the patient is overweight (more than 130 kg) and has a large waist circumference, exceeding the diameter of the MR capsule.
• Relative contraindications are:
• — claustrophobia (when conducting research in closed devices). 
• - severe somatic condition of the patient (if the patient is connected to a ventilator or other device, then it is necessary to wait for a state when it will be possible to maintain vital functions without the device), as well as mental disorders (it is necessary to compensate for the acute condition with medications).
• - examination of the pelvic organs in women is not carried out during menstruation, except in cases where it is necessary to make a differential diagnosis if a hormonal-dependent tumor is suspected.
• The presence of an intrauterine device (except for a copper device) and lactation are not contraindications to MRI of the pelvic organs.

When using contrast agents, the following contraindications will be added to the above contraindications: 

- pregnancy at any stage, because There is not yet enough data available on the possible harm to the fetus when using gadolinium-based drugs.  

— during lactation it is not recommended to put a baby to the breast for 24-48 hours. Milk must be expressed after the examination.

— in case of renal failure, contrast-enhanced studies are also possible. The most serious complication in patients with severe kidney damage is nephrogenic systemic fibrosis.

Most often, this complication occurred after using Omniscan and Magnevist.

Therefore, these drugs are not recommended for use in patients with creatinine clearance less than 30 ml/min/1.73 m2.

- positive allergy history.  

If the patient has no contraindications, then MR imaging and contrast-enhanced MR imaging can be performed as often as required to clarify the diagnosis or when monitoring the dynamics of the disease. Alternative research methods in the presence of contraindications, as well as cheaper ones, are ultrasound or CT.

Source: https://xn—-xtbekk.xn--p1ai/article/protivopokazaniya-vred-mrt-malogo-taza