Pelvic MRI is an ultrasound examination. All the organs contained in the pelvic cavity are visible (uterus, ovaries, rectum, bladder …) as well as the veins and arteries. It allows a complete anatomical assessment. What are the indications? Answers with Dr. Florence Girodon.
Definition: What is a pelvic MRI?
“Pelvic MRI is a examination performed in addition to an ultrasound when the latter is not sufficient, explains Dr. Girodon, a radiologist. All the organs contained in the pelvic cavity are visible (uterusovaries, rectum, bladder…), as well as veins and arteries“. It may be necessary to inject a contrast agent.”MRI can be useful in several cases, including pelvic carcinological pathologyin the inflammatory and infectious diseases, the chronic or acute pain“.magnetic resonance imaging (MRI) does not use X-rays, unlike scanners or X-rays. “The principle of MRI is based on magnetic properties of the hydrogen atom content in the human body in different proportions depending on each tissue and organ. By using very powerful magnets, and radio frequency waves, one is able to stimulate the protons of the hydrogen atoms in the body and collect the energy associated with this stimulation and the return to rest of these protons.“. The analysis of the data will result in an image of the human body. The computer analysis then makes it possible to reconstruct an image of the studied area in 2D or 3D.
Directions: Why do a pelvic MRI?
“Most of the time second intention, pelvic MRI can be used to assess different pathologies“, continues our specialist. In particular:
- Do it diagnosis and therapeutic follow-up of pelvic carcinological pathology (cervical cancer uterine cancer, endometrial cancer, ovarian cancer)
- Search for one endometriosis during a pelvic pain recurrent.
- As part of a inflammatory or infectious pathology, uterine or ovarian. To look for atypical lymph nodes, adhesions, unusual infiltrations
- To assist in the therapeutic decision of uterine fibroids.
- To help diagnose ovarian cyst by establishing criteria of benignity and malignancy for the therapeutic decision
- During the pelvic static disorders (bladder prolapse, uterovaginal, rectal…)
- For everything pelvic pathology whatever it is, it provides anatomical information about the various pelvic organs.
“Depending on the request made by the general practitioner or specialist, the radiologist will decide whether it is necessary to perform a evacuation enema a few hours before the exam, if necessary fasting (usually six hours before the exam) or if you need to have one bladder full or empty“Sometimes the cycle can be important for some explorations,” she said.
Do you have to be fast to do a pelvic MRI?
“At the request of the prescribing physician, the patient may be asked to fast (usually six hours before the exam) “.
“On the day of the examination a radio manipulator will lead the patient into a box, details our interlocutor : he will have to remove personal belongings, metal objects, especially jewelry. He puts on his underwear and is offered a tunic“. Then it will be installed in the lying on the examination table in order to proceed with the exploration. “It is possible for the radio manipulator to install a venous line to allow an injection. The examination table will move to place the exploration area in the tube of the MRI machine “. It is important while exploring stay still, and follow the instructions of the specialist operator. “It’s a painless and rather noisy examination but ear plugs are offered.” Pelvic MRI depending on the pathology lasts on average between 15 and 30 minutes.
“It simply came to our notice then radiologist who decides on the protocol to be followed according to the pathologyanswers Dr. Girodon. At the end of the examination he will give an oral result to the patient first. He will leave later with his report and the shots taken“.
What to do in case of an abnormal result?
“If the results are abnormal, the radiologist will prompt the patient to see his or her doctor general practitioner or specialist with the exam. Depending on the anomaly, he can call his doctor to let him know so that he can have a faster appointment.“.
What are the risks of a pelvic MRI?
“It simply came to our notice then painless and very well tolerated“It sometimes requires an injection of gadolinium salt contrast agents. This product does not contain anyiodine. “It is injected intravenously. It is usually very well tolerated with very rare allergic manifestations. “
What are the contraindications to pelvic MRI?
“There is an absolute contraindication that is the existence of metallic luster in the eyes, alert the radiologist. However, in case of risk of intraocular straw, an X-ray of the orbits is performed to confirm it and an ophthalmological appointment was given in order to remove the straws to allow the MRI to be performed later.“. Les old heart valves may also be absolute contraindications, but laboratories are increasingly developing compatible equipment. “There is a regularly updated list of heart valves and their compatibility that is regularly consulted before an examination.“Generally, joint prostheses (knee, hip…) are compatible but can lead to artifacts and decreased test quality.”The wearing of a pacemaker is often an absolute contraindication. “However, as more and more pacemakers become compatible, you simply need to make an appointment with a cardiologist before and after the MRI scan because a quick adjustment is needed (to put the pacemaker in compatible mode). “
What is the price and reimbursement of a pelvic MRI?
“There is a € 166 technical package covered by social security, concludes Dr. Girodon. The intellectual act is € 69.75, 70% covered by social security and 30% by the mutual society“.
Thanks to Dr. Florence Girodon, a radiologist in St Etienne, a member of the Elsan network.