MRI of the pelvis in women is a safe and effective method for diagnosing diseases of the female genitourinary system. This is an absolutely painless and safe procedure that does not use X-rays or other dangerous types of radiation. What does an MRI of the pelvis show in female patients?
The images obtained during the study are the result of computer processing of data on the complex interaction of magnetic fields and radio waves. The images show the structure of the pelvic organs and any possible pathological changes, based on the amount of water contained in the tissues.
Anatomy of the female pelvis
The small pelvis is the space bounded by the symphysis pubis in front and the promontory of the sacrum in the back. On the sides, the boundaries of the small pelvis run along arcuate lines separating the body of the ilium from the wings. The pelvic cavity in women serves as a container for the genital organs - the uterus and its appendages (ovaries, fallopian tubes). There are a large number of blood vessels, nerves and fiber. The pelvic cavity also contains the rectum and bladder.
Are there any restrictions for ultrasound diagnostics?
When a woman suffers from pain during menstruation, or her cycle is unstable for a long time, the gynecologist gives a referral for an ultrasound. To obtain information about the condition of the fallopian tubes and follicles, it is important to conduct the examination on days 5-7 from the first day of the cycle, that is, from the day of menstrual bleeding.
But if you want to find out the cause of problems with conception, research must be carried out at least three times:
- from the 8th to the 10th day from the beginning of menstruation;
- from the 14th to the 16th day from the first day of bleeding;
- from the 22nd to the 24th day of the cycle.
For pregnant women, there are also certain time frames for assessing the condition of the fetus. Conducting an ultrasound examination at other times is not considered informative. Each trimester of pregnancy has its own weeks for diagnosis:
- from 10th to 14th week;
- from the 20th to the 24th week;
- from the 30th to the 34th week.
If there are suspicions of pathologies, the number of studies can be increased to determine the condition of the fetus over time.
Diseases of the pelvic organs in women
Main diseases of the female genitourinary system:
- Inflammatory diseases (salpingitis, oophoritis, endometritis, cervicitis, cystitis);
- Ovarian apoplexy;
- Polycystic disease;
- Torsion of the uterine appendages;
- Polyps, synechiae of the uterine cavity;
- Endometriosis, adenomyosis;
- Ectopic pregnancy;
- Endometrial hyperplasia;
- Bleeding;
- Infertility;
- Bladder polyposis;
- Benign and malignant neoplasms of the female genitourinary tract;
- Malformations of the female genitourinary system.
In addition, MRI is used to diagnose diseases of the rectum - Crohn's disease, polyps, perirectal abscesses, fistulas, and neoplasms.
Indications for MRI of the pelvic organs in female patients
The following symptoms may be the reason for a more in-depth examination with the appointment of magnetic resonance imaging:
- Pain in the lower abdomen, radiating to the perineum, tailbone, lower back, lower limbs;
- Dyspareunia;
- Pathological discharge (blood, pus);
- Pathological impurities in the urine;
- Miscarriage, infertility.
Contraindications
The powerful magnetic field during an MRI exam can interfere with electronics and dislodge metallic foreign bodies. Therefore, MRI is contraindicated if the patient has:
- Electronic implants - hearing processors, defibrillators-cardioverters, artificial heart pacemakers, insulin pumps, neurostimulators;
- Ammunition fragments, shot, small particles of iron in the eyeballs (often found in metal workers), vascular stents, clips on the arteries of the brain made of surgical steel.
MRI of the pelvic organs is not recommended during pregnancy before 12 weeks due to the lack of experimental data on the effect of magnetic fields on the developing fetus. The study in children under 5 years of age is carried out only in a specialized clinic under the influence of sedatives that put young patients into medicated sleep.
A serious obstacle to the study is the patient’s weight more than 130 kg and torso girth more than 150 cm. The reason is that the working part of the MRI machine - tomograph - is a tunnel with a diameter of 60 cm, which is too small for obese patients.
Weakness of the pelvic floor muscles: problems and consequences
If your pelvic floor muscles are weak, you are at risk for the following problems:
- anorgasmia (loss of sensation and inability to experience sexual pleasure);
- urinary incontinence while walking, coughing, playing sports;
- prolapse and prolapse of the uterus outside the vagina;
- severe abdominal pain.
20% of women aged 21–29 years and 55% of women aged 30 to 40 experience certain symptoms associated with weakening of the pelvic muscles. In the age group over 45 years old, muscle weakness occurs in 75% of cases. If you ignore the problem, the condition progresses, causing complications.
MRI of the pelvis in women with contrast
Contrast is a special solution for intravenous administration containing nanoparticles of gadolinium, an element of the periodic system that can accumulate in pathologically altered tissues. Contrast enhancement is an MRI technique that involves the administration of a contrast agent during the examination. Contrast helps detect some diseases of the pelvic organs, such as acute and chronic inflammatory processes, cysts, benign and malignant neoplasms. This technique is indispensable in controversial and complex cases, as it can increase the sensitivity and specificity of MR imaging.
Contrast is injected midway through the pelvic MRI into the cubital vein using a routine intravenous injection. After administration of the drug, the study is repeated with contrast enhancement, which increases the duration of the procedure by 15 minutes. Contrast agents are safe, well tolerated by patients, and rarely cause allergic reactions.
When is ultrasound indicated?
Ultrasound of the pelvis in men is a method for detailed diagnosis of the condition of most organs in this area, based on the results of which a medical specialist assesses the health status of organs located in the abdominal area: seminal vesicles, prostate. Through ultrasound, the clinical picture of changes in the lymph nodes located next to the prostate becomes clear. There are indications for ultrasound of the pelvic organs in men:
- complaints of pain when urinating;
- if there are purulent and other masses in the urine;
- diagnosing renal colic;
- suspicion of cancer,
- preparation for surgery and after it in order to clarify the dynamics and effectiveness of treatment measures.
Preparation for MRI of the pelvis in women
The study is carried out after preparation. The quality and clarity of the resulting images is greatly influenced by the intestines, the wall of which contracts rhythmically, moving the bolus of food. These movements, called peristalsis, are transmitted to the pelvic organs and can distort the image. In order to reduce the effect of peristalsis on the quality of images, 8-12 hours before the MRI examination you need to take an antispasmodic and carminative (no-shpu, espumizan, simethicone). No-spa will relax the intestinal wall, make peristalsis softer, and espumisan will reduce the formation of gases that irritate the intestines and increase its rhythmic contractions.
MRI diagnostics of the pelvic organs is best performed between the 5th and 12th day of the menstrual cycle. If menstruation is absent or has not yet begun, the test can be done on any day.
There are certain safety precautions that must be followed when preparing for an MRI scan. Due to the presence of powerful magnetic fields, it is prohibited to bring any metal objects (tools, cigarette cases) and electronic devices (smartphones, gadgets) into the study. Metal heats up in magnetic fields and can cause burns and damage electronics. For the same reason, it is necessary to carefully ensure that the patient’s body is free of piercings, jewelry, and metal fittings do not touch the skin. Violation of these rules may result in injury.
Ultrasound methods
There are two types of sensors that are used for research. One is called transabdominal. It is enough for a specialist to apply it tightly to the body so that the ultrasound waves begin to show the internal organs.
Another type of sensor is called transvaginal. Based on the name, it is easy to guess that it is inserted into the vagina to look at the organs from a different angle. To conduct such a study, the doctor places a condom on the sensor to ensure sterility. Budgetary institutions often ask patients to buy it for themselves if the deposited funds are not enough to provide the office with consumables.
In addition, there are stationary and mobile devices. Ultrasound diagnostic rooms are equipped with stationary ones. The doctor can take the mobile device with him to visit patients at home. Modern ambulances are also equipped with such equipment.
How is an MRI of the pelvis performed in women?
The duration of the study is 40 minutes (55 when using contrast). Diagnostics begins with placing the patient in a tomograph - a cylindrical device with a tunnel in the center 60 centimeters long and wide. To accommodate the patient, the tunnel is equipped with a movable table. After laying the patient down, the medical professional will ask you to put on headphones - they are needed so that the noise from the tomograph does not interfere with the examination (as well as to communicate with the operator and listen to music, which helps to relax and reduce the wait). The patient is given a button on a wire - by squeezing it, you can contact the operator via intercom.
Please remain still throughout the entire examination. Follow all operator instructions - you may be asked to exhale or hold your breath. Try to relax and remain calm - the procedure is absolutely safe and will not cause harm.
After completing the procedure, you must wait 15-30 minutes until the results of your examination are deciphered. After this, you will receive a written report from the radiologist and images on a CD. For convenience, images can be ordered on film or on a flash drive - not all doctors have the opportunity to view CDs (you need to pay a little extra for this).
What does a pregnant ultrasound tell you?
Pregnant women can refuse a routine examination with an ultrasound machine, but this is not recommended, because this painless type of diagnosis allows you to find out about very important changes in the child’s body, in particular, whether he has Down syndrome. According to the regulations of conduct, a medical worker is obliged to notify future parents about a serious genetic disease that entails disability from birth. In this case, the woman is given a complete plan of action if she decides to terminate the pregnancy. The antenatal clinic is obliged to provide all necessary medical care, regardless of the long period of time.
If there is a risk of miscarriage, the gynecologist will monitor the condition of the cervical canal, the length of the cervix and the location of the placenta.
Additionally, ultrasound can easily detect oligohydramnios, as well as:
- quality of blood flow, its intensity;
- location of the umbilical cord for entanglement;
- fetal heart rate;
- fetal presentation.
With the help of a modern three-dimensional imaging system, the expectant mother can see the face of her unborn child, which always cheers up a pregnant woman.
Deciphering the results of MRI of the pelvis in women - what the study shows
Interpreting the results of MRI of the pelvis is the job of real professionals. Each resulting image in the form of a 1-2 mm thick slice taken in several planes is the result of computer data processing, conveying the anatomy of the pelvis in great detail. During interpretation, the radiologist pays attention to the size, shape and position of the internal genital organs, bladder and rectum.
The anatomy of each organ is examined in detail, and deviations from the norm are searched for. The method allows you to “see” any space-occupying formation, be it a cyst or tumor, inflammatory processes, or anomalies in the structure of organs. When using contrast, attention is paid to the local accumulation of the drug, the dynamics of its absorption and release - these parameters make it possible to establish a diagnosis with almost 100% accuracy.
How the study is conducted and what you need to know
Carrying out diagnostics, as a rule, does not require special preparation, with the exception of the condition of the bladder, which the doctor will warn you about in advance. When a patient enters the office, she should remember that it is advisable to turn off her mobile phone during the examination.
After presenting her documents to the doctor, the woman can go to the couch. If the examination is carried out with a transabdominal sensor, it is not necessary to undress completely - you just need to lower your pants or lift your dress so that the lower abdomen is free from clothing.
When examined with a transvaginal probe, the patient must completely remove pants, tights and underwear. Her position on the couch is lying on her back with her knees bent.
It should be noted that neither one nor the other sensor causes any discomfort. The procedure is completely painless.