How do and what are the indications for performing MRI of the pelvic organs in men and women?
Pelvic MRI is magnetic resonance imaging of the pelvis. The small basin is called the lower, narrow part of the pelvis, conventionally from the pubic bone and below. In the pelvic area are the large intestine, urinary bladder, urethra, uterus (in women) and prostate, testes, and other elements of the genitourinary system (in men). Magnetic resonance analysis is based on the fact that the object is illuminated with electromagnetic waves of different frequencies. not to go into technical and physical details of the work of the MRI machine, just describe: nuclei of different chemical elements respond differently to electromagnetic influence. As a result of various chemical elements and their compounds (which make up the cells of an organ) look different in the picture. This gives you the ability to clearly see every body and see it change (for example, tumors or traumatic sores).
The Term “MRI-pelvis” is somewhat incorrect, because the small pelvis (bones and articulations) does not make sense to analyze with the help of MRI. There is enough x-ray. Using the MRI machine is usually examined organs located in the pelvic area. Therefore would be correct to say “MRI of the organs in the pelvic area”.
Why MRI and not ultrasound?
It's a legitimate Question. In many cases, indeed, is used, ultrasound of internal organs and other simpler methods of diagnosis. Inspection method of magnetic resonance imaging is appointed only as a last resort if other methods of examination not given a clear picture for diagnosis, and requires detailed clarification of the operation and the condition of an organ.
In our body organs are located very closely. In the pelvic area in particular. Therefore, the anomaly of one organ may affect another. But, worst of all, in this case, while other types of survey, this anomalous body may block the view of another.
So, for example, many women who already have been examined on ultrasound in gynecology, I know that on this study we recommend that you arrive with a full bladder. Why? The fact that the uterus is located just above the bladder and a full bladder lifts. For the same reason (the location of the uterus on the bladder) pregnant women often experience the urge to urinate.
It is Important to understand the symptoms or diseases are associated only with inflammation of one organ and is caused when the tumor presses one body to other or two bodies are sick, just closed the second problem from the review of the first tumor. In this case, and requires an MRI of the pelvic organs.
When the ultrasound to, for example, you can see the problem only one organ, and the lab tests and the occurrence of a disease emerges that has to hurt the other body. Disease of one body affects the health of others, but in this case, the disease of one organ does not exclude concurrent illness other (or that other body may be the cause of the disease).
First of all, when administered survey with the help of the MRI machine, don't panic. In some cases, the test is scheduled to ensure that there are no hidden anomalies, and does not require surgical intervention.
The Reasons for the examination in the MRI apparatus of the pelvic organs in women are most often problems of the uterus, ovaries, vagina.
- pain in the lower abdomen or lower back;
- severe pain during menstruation
- menstrual cycles
- blood spotting.
In men, urinary and reproductive system combined into one. To separate them, there is no possibility (for example, the prostate gland surrounds the urethra).
- pain in the lower abdomen;
- erectile dysfunction.
In addition, for both men and women MRI of the pelvic organs may be appointed in the following cases:
- problems with urination, pain;
- suspected of having a tumor;
- suspected adhesions
- assess the condition of the pelvic organs (undergoing surgery)
- clarify the diagnosis, with conflicting results of other analyses;
- trauma pelvic;
- in the preparation and planning of operations.
Preparing for your MRI scan has no special requirements. The usual recommendations when testing for urogenital digestive system:
- the bladder should be empty (or minimally filled)
- before the examination you should make an enema;
- 2-3 days beforeexamination not to eat junk food, liquid;
- it is desirable to hold the examination on an empty stomach;
- in some cases (e.g., abdominal pain) allowed the use of antispasmodic drugs.
In some cases, a so-called MRI with contrast. It is necessary to enhance the contrast in MRI that shows a picture, and more clearly make a diagnosis. It requires the introduction of (IV) a special solution, which stains the fabric. This solution is made on the basis of iodine. If you have an intolerance to iodine preparations iodine-based, you should notify the doctor. Otherwise there is the risk of MRI studies in an ICU.
It is Obvious that studies conducted using electromagnetic radiation of high frequency, can have its downside. How do MRI? The patient is placed in an electromagnetic field and using a special modulator is selected the frequency of the radiation, such that the organ was in a state of resonance with this electromagnetic effect. At the right angle the picture is taken.
First of all, it should be noted that "any magnetic field generates an electric current and Vice versa, an electric current is a magnetic field source" (school textbook on physics). Thus, if the body has electrical devices (e.g. Cardiac pacemakers), magnetic resonance imaging is absolutely contraindicated.
You Also can not use this type of research in the presence of implants made of metals or other magnetic materials. It is prohibited to use MRI with implanted electronic devices (for example, for delivering drugs). And the last limitation is claustrophobia (fear of closed spaces).
Diseases that can be diagnosed by MRI
Endometriosis. This disease is truly an epidemiological scale. A huge number of women suffer from this disease. Its essence lies in the fact that the cells of the inner layer of the uterus grow beyond this layer. It causes inflammation in the surrounding tissues. May be accompanied by pain, increased range, even lead to infertility. Moreover, this impact may be provided on the reproductive system of women, and to adjacent organs (bowel, for example). In most cases, the ultrasound finding of this disease, but in severe cases (e.g., adhesions) without MRI of the pelvis can not do.
Endometrioid ovarian cysts. The cyst may be located on the side of the uterus and back. In the case of several cysts may occur adhesions, and spike can occur not only from the uterine wall, but also with the adjacent intestine. Working with magnetic resonance imaging according to the method, it is possible not just to see these cysts, but also to determine their content and consistency (liquid, thickened, etc.).
uterine Fibroids. This disease (it is also called a fibromyoma or leiomyoma) is a benign tumor in the uterus. This is the most common disease in gynecology. The percentage of all gynecological diseases is around 20%.
That is 1 out of 5 women having a gynaecological problem the character suffers from uterine fibroids. Traditionally the disease is treated surgically, but recently began to appear non-surgical methods of treatment of this disease.
Hematocolpos. This disease is expressed in the accumulation of menstrual blood in the fallopian (uterine) tubes. MRI in the picture it looks like the expanded fallopian tube, with hemorrhagic content, which, in fact, and it has expanded.
Cysts luteum and follicular. This is some education that occurs in violation of hormonal background. The distinction of follicular cyst from the cysts of the corpus luteum is the formation of a seal (capsule) inside the cyst. Follicular cysts usually resolve themselves when you normalize hormonal levels and do not require surgical intervention. With a cyst of a yellow body a little harder and longer, but surgery is used only in case of serious complications. Conditional cause of such cysts is that excessive amounts of the hormone progesterone, and during pregnancy the cyst does not resolve, but grows further (the yellow body of pregnancy).
Teratoma. This tumor from gonocytes that appears in the ovaries (in women) or testicles (in men). This tumor may occur in the sacrococcygeal region in both sexes and in children. The composition of this unusual tumor, because it is innate. It can be hair, bone or muscle tissue, in more rare cases, even eye. According to the present scientists, the disease is caused by the extremely underdeveloped Siamese twin of the man and formed in the womb. It is such a theory at this point adheres to mainstream scientists, although, but in fairness, we note that not all. But because of the theory that describes the appearance of this tumor is better at the moment, we accepted this.
The problems of the development of the urogenital system.Different types of aplasia (absence of a portion of tissue part of an organ or the body as a whole), as well as options of doubling (e.g., cancer). Hematocolpos (accumulation of menstrual blood in the vagina). This disease may occur when narashivanie the hymen, for example. This disease can be treated at the moment exclusively by surgery, as it has in the most part not medical, but purely mechanical basis. Usually the problem is solved by the dissection of a partition.
In conclusion, it is worth noting that in gynecology, urology in most cases, ultrasound is used. This paper is, as a rule, sufficient to assess the condition of the internal organs of the pelvis. However, MRI is increasingly used for diagnosing diseases of the small pelvis.
Most frequently, MRI is used to diagnose diseases of the brain. In many cases, only this method of study gives the results. But for diseases of the pelvic organs, as can be seen, this type of research is well founded. Many of the problems of these organs are hidden due to the density of the location, and the same ultrasound machine shows all together, without being able to do the cut in a particular plane for more accurate diagnosis. In this case, the picture shows the same slice can show more clearly and intensely only that body that you want. You should only to choose the right frequency and the modulation of electromagnetic waves. This property is currently largely inhibits the widespread use of MRI apparatus in hospitals, because MRI done only by a qualified service technician of the device. The second limiting factor is, of course, price. But I hope that over time this method of research will also be simple and available as now ultrasound.
Marchenko N. In., Trofimenko I. A. Differential diagnosis of ovarian neoplasms.