Diagnosis

MRI of the pelvis

definition

Magnetic resonance tomography, or MRT for short, is an imaging method that is widely used in medicine in particular. With the help of a strong magnetic field, organs, tissues and joints can be displayed in the form of sectional images during an MRI examination and finally assessed for pathological changes.
Due to its good soft tissue contrast and high resolution, MRI of the pelvis is well suited to depicting pelvic organs such as:

the rectum
the urinary bladder
such as
the prostate in men
and
the uterus
and
of the ovaries in women.

For this reason, the pelvic MRI scan is now an extremely important diagnostic tool and is used in a wide variety of diseases of the pelvic organs.

Procedure

The MRT examination may need to be carried out with a contrast medium for better representation

In the MRI of the pelvis it is a imaging procedurewhich not invasive is. That means that to represent the Organs of the pelvis, how rectum, bladder, prostate, uterus or Ovaries, no instruments need to be inserted into the body.
The pelvic MRI works with the help of a strong magnetic field. Put simply, the magnetic field generated by the MRI machine causes a Excitation of atomic nuclei, especially the hydrogen atoms, in the patient's tissue to be examined. The hydrogen atoms are excited to move in a certain way and emit a measurable electrical signal. These measured signals are then converted into image information.
Because different fabrics make one different content of hydrogen atoms and hydrogen atoms behave differently depending on the tissue, different tissues can be differentiated using MRI. The differentiation of different tissues can be achieved by the additional administration of a Contrast agent, for example the well-tolerated one Gadolinium DTPA, be simplified.

In the picture, the different fabrics are finally shown in different shades of gray. The MRI stands out over other imaging techniques, such as roentgen or Computed Tomography (CT) through a better one Soft tissue contrast which is created by a different water and fat content of different tissues and is therefore very well suited for displaying the Pelvic organs, how Rectum, urinary bladder, prostate, uterus, or ovaries.
Another advantage over other imaging methods is that the MRI of the pelvis works with the help of a magnetic field and without harmful X-rays or ionizing rays gets by.
However, the disadvantages are high expenditure of time for an MRI examination as well as the high power consumption of the MRI machine.

Implementation / procedure

The patient is moved into the MRI tube up to the level of the pelvis

A MRI the pelvis can be done in a hospital or in a radiology practice. Before the MRI of the pelvis can be done, it must be clarified whether the patient metal-containing objects carries with him, as these are destroyed by the MRI examination, impair the image, but can also lead to injuries to the patient. This is done using a survey by the doctor or the nursing staff.

Questioning the patient about objects containing metal is extremely important because the MRI of the pelvis uses a strong magnetic field works, which attracts metal-containing objects. If the objects are attracted during the MRT examination, they can damage the MRT machine on the one hand, but also damage the MRT device on the other Injuries to the patient cause.
This is especially true with implanted metal parts, such as Pacemaker, Dentures or Piercings the case.
In addition, the metal parts in the MRI machine can become strong heat and so Burns cause in the patient. For these reasons, all objects that could contain metal should be placed in a cubicle before an MRI scan of the pelvis.
This includes garments with metallic Zippers, Button or Rivets, Clocks, Jewellery, key, check- or Credit cards.
Also Cosmetic products can contain metal particles, which can lead to local burns, which is why you should remove your make-up before an MRI of the pelvis.

If objects containing metal, such as a pacemaker or a prosthesis (with the exception of hip and knee prostheses) cannot be put down, the MRI of the pelvis is usually allowed not done become. An individual decision by the doctor is required here.

After removing all potentially metal-containing objects and items of clothing in the cabin, the patient is allowed in the MRT machine, one tunnel-like tube with a diameter of about 70 to 100 centimeters, take a seat. The patient to be examined is then moved into the tube on a movable couch up to the level of the pelvis and the pelvic organs are recorded and displayed. This process takes about one half a hour.
During the investigation will be relative loud, knocking noises generated. Since these are sometimes perceived as very annoying, earplugs or closed ear protection can be used to dampen the noise. In some hospitals or practices, music can also be heard during the MRI scan of the pelvis.
In patients suffering from claustrophobia, colloquially Claustrophobia , the MRI scan of the pelvis is more difficult and can, if the feeling of tightness is severe, in Short anesthesia respectively. In general, however, when examining the pelvic organs using MRI, the Head outside the tube which reduces the feeling of tightness.
If you are claustrophobic, read the topic: MRI for claustrophobia

An MRI scan of the pelvis can without contrast agent (native) and with contrast agent respectively. If the administration of contrast agent is necessary, for example for a detailed representation of different tissues, this is done at the beginning of the examination via a vein at the poor or at the hand applied. Can through the contrast agent Blood vessels better from Musculature and other surrounding tissues.
The administration of contrast media is important for diagnosing, among other things Tumors the pelvic organs, such as Bladder cancer or Prostate cancer. Tumors are usually heavily supplied with blood, so that during the MRI examination of the pelvis with administration of contrast agent, the contrast agent is also enriched in the tumor and tumors of the pelvic organs become more visible.
A frequently used contrast medium is the so-called Gadolinium DTPA, which is usually well tolerated. In many cases, two MRI images are taken, first without contrast agent (native) and then with contrast medium.

Cost of an MRI scan of the pelvis

An MRI examination costs between, depending on the question and with / without administration of contrast medium 400 and 800 Euro for privately insured.
If the indication is correct, the costs of an MRI examination of the pelvis are both statutory and private Health insurance accepted.

You can find more detailed information on our website: Cost of an MRI examination

Indication for an MRI of the pelvis

The MRI of the pelvis is a very precise and non-invasive procedure and is therefore often used when pathological changes in the pelvic organs are suspected, such as Rectum, urinary bladder, prostate, uterus, or ovaries carried out.
Pathological changes in the pelvic organs that can be identified with the help of an MRI of the pelvis include tumors (amongst other things Bladder cancer and Prostate cancer) or enlargements (for example Prostatic hyperplasia) of the pelvic organs.
Inflammatory changes such as abscesses, fistulas or fissures in the area of the pelvic organs can also be visualized with the help of an MRI of the pelvis.
An MRI of the pelvis can also be used to visualize the surrounding structures, such as muscles, ligaments, vessels or lymph nodes in the pelvic area.
In addition, if there is persistent back pain in the lower back, joints such as the sacroiliac joint can be assessed in order to rule out osteoarthritis, for example.

Also read our article on this topic MRI of the sacroiliac joint

Contraindication

Pelvic MRI is used to diagnose abnormal changes in pelvic organs very important and is done frequently these days.

However, there are also factors in which performing an MRI scan of the pelvis is prohibited or may only be performed in exceptional cases.
These so-called absolute and relative contraindications (Contraindications) count the presence of a Pacemaker, one ICD (implanted defibrillator), a mechanical one Heart valve, different Implants and Prostheses or metallic foreign bodies.

Great tattoos in the area of the investigation are also a contraindication, as tattoos contain metal-containing color pigments which heat up and close in the magnetic field Burns the skin.

One in the first three months too pregnancy an MRI of the pelvis should not be performed, as according to current studies, damage to the unborn cannot be ruled out. In the following weeks of pregnancy, however, the pelvic MRI may be performed.

Read more about this at: MRI during pregnancy - dangerous?

Does a patient suffer from claustrophobia (colloquial Claustrophobia) this is a relative contraindication; the examination can be found here under Short anesthesia respectively.
With a well-known allergy against contrast media or with one Kidney disease The administration of contrast medium should be avoided during the MRI of the pelvis and instead a native MRI, i.e. an MRI of the pelvis without the administration of contrast medium, should be performed.

Risks and Complications

According to current studies, an MRI of the pelvis is a Risk-free and side-effect-free examination procedureas compared to other imaging techniques such as roentgen or Computed Tomography (CT), no harmful MRI of the pelvis X-rays or ionizing rays be used.

Risks or complications arise mainly from failure to observe Contraindications (Contraindications) for an MRI examination of the pelvis, for example if metallic objects are not put down before the examination.
Objects containing metal are drawn into the magnetic field of the MRI machine and can thereby Injuries to the patient to lead. It can also be through a strong heat development metallic objects in the magnetic field, which are strong Burns can cause in the patient.

In patients who have a Pacemaker wear, no MRI examination of the pelvis should be carried out, since the magnetic field here not only poses the risk of injury from the acceleration of metallic parts of the pacemaker, but also the risk of a Loss of function of the pacemaker.
In patients taking claustrophobia (colloquially claustrophobic), there is a risk that lying in the narrow tube of the MRI machine will lead to anxiety Panic attacks comes. To avoid this, patients suffering from claustrophobia can have an MRI scan of the pelvis in Short anesthesia respectively.

In some cases, using a Contrast agent for better differentiation of different tissues, for example for Identification of tumors of the pelvic organs. With the frequently used Gadolinium DTPA it is usually a well-tolerated contrast medium.
There are seldom side effects such as Skin irritation, tingling sensation up to pain at the application site, malaise, nausea, a headache or allergic reactions against the contrast agent.