Pelvic Magnetic Resonance Imaging (MRI)

Pelvic magnetic resonance imaging (MRI) is a non-invasive and completely safe radiological method that provides detailed and precise imaging of pelvic structures. This method is crucial for diagnosing tumor diseases and other pathological conditions within the pelvic cavity. During the scan, the patient is not exposed to harmful ionizing radiation, and the use of contrast agents further enhances the sensitivity of the examination.

 

What is pelvic MRI?

Pelvic MRI is a radiological method that utilizes a strong magnetic field and electromagnetic waves to provide detailed imaging of soft tissue structures in the pelvis. In both sexes, the bladder and rectum are examined, as well as the uterus and ovaries in women, and the prostate in men

This radiological method relies on a strong magnetic field and electromagnetic waves that affect the alignment of protons in the tissues relative to the magnetic field. As protons return to their original positions, energy is released, so-called signals through which the image of the interior of the pelvis is ultimately obtained in the computer Different types of tissues in the MRI scan can be distinguished based on their magnetic properties and the strength of the signals they emit.

When is pelvic MRI needed?

Pelvic MRI, along with CT, is an optimal radiological method for the detailed assessment of pelvic abnormalities. It is typically indicated when further evaluation of a pathological finding in the pelvic cavity is needed based on symptoms and initial ultrasound findings.

MRI of the uterus and ovaries

Whether performed as part of routine annual check-ups or following unusual symptoms, gynecological ultrasound is the primary diagnostic method for gaining insight into the female pelvis. However, due to limitations in characterizing types of lesions in the female reproductive system and the restricted field of view, pelvic MRI may be indicated for clearer imaging.

Non-specific symptoms that may indicate the need for MRI include:

• Chronic pelvic pain
• Painful and heavy menstruation
• Abnormal uterine bleeding

Symptoms related to conception and pregnancy that may require MRI evaluation include:

• Infertility
• Recurrent miscarriages
• Preterm labor and other childbirth complications

Pelvic MRI may be indicated to:

• Differentiate between tumor types and benign versus malignant lesions of the uterus and ovaries (especially when the lesion is larger than 5 cm in premenopausal women and larger than 3 cm with growth in menopausal women)
• Assess the extent of endometriotic tissue (endometriosis)
• Locate benign tumors of the uterus (fibroids) and monitor them after uterine procedures (e.g., embolization of blood vessels)
• Check for the presence of adenomyosis

MRI of the prostate

Prostate MRI may be indicated following an ultrasound examination when a better assessment of detected abnormalities is needed: presence of tumors, inflammatory processes, abscesses, prostate enlargement, postoperative complications, or congenital anomalies.

In prostate disease diagnosis, MRI is crucial for determining malignant changes and their spread to surrounding tissues.

MRI of the bladder/rectum

In the diagnosis of bladder and rectal diseases, MRI plays a key role in detecting and assessing the stage and extent of malignant changes. Accurate assessment of tumor size and location is essential for optimal treatment planning and evaluating disease severity.

What does pelvic MRI show?

This examination can diagnose a range of abnormalities and precisely image the anatomy of the male and female pelvis:

• Detect tumors of the uterus and ovaries and determine their size and location
• Differentiate between types of lesions and assess the nature and extent of disease (benign or malignant)
• Detail the anatomy of the uterus and any congenital anomalies
• Determine the presence of endometriosis and/or adenomyosis
• Identify tumor changes in the bladder and rectum and assess disease stage
• Confirm the presence of adhesions (which may be caused by endometriosis, pelvic inflammatory disease, or previous surgeries)

The use of gadolinium-based contrast agents allows for clearer tissue imaging and differentiation of lesion types, though its application depends on the indication.

Duration of pelvic MRI

The scan typically lasts between 30 and 60 minutes, depending on the indications. The entire procedure takes slightly longer if a contrast agent is used.

Preparation for pelvic MRI

• Preparation depends on what is being examined, and you may receive instructions regarding food consumption and bowel cleansing the day before the scan.
• Fasting: Do not eat for 4 hours before the scan.
• If the bladder is being examined, it is preferable to have it half full.
• Contrast agent: If a contrast agent is indicated, bring recent results of urea and creatinine tests.
• Metal objects: Remove all metal items that could interact with the MRI magnetic field, including jewelry, piercings, glasses, mobile phones, keys, watches, credit cards, metal hair accessories, and removable dental prosthetics.
• Clothing: Wear clothes without metal parts (e.g., buttons, zippers) or prepare to change into provided attire.

Anxiety: If you are anxious about enclosed spaces, you may take a mild sedative 15 to 30 minutes before the exam.

Risks of MRI

Pelvic MRI is a completely safe imaging technique with no exposure to harmful ionizing radiation.

However, the MRI device resembles a tunnel, and the confined space may trigger claustrophobia in some individuals. At Poliklinika Sinteza, we use the Siemens MAGNETOM® Aera MRI device, known for its open design (70 cm tunnel width and 145 cm length), which reduces the feeling of enclosure and provides a more comfortable experience.

Due to the use of a strong magnetic field, MRI is contraindicated for patients with a cardiac pacemaker or implanted cardioverter-defibrillator.

Although the effects of MRI on pregnancy are not scientifically proven, it is recommended only in strong medical indications for pregnant women.

The MRI procedure

• Pre-scan: Complete a health questionnaire and remove all metal items and clothing containing metal.
• Positioning: The radiologic staff will place you in a lying position inside the MRI tunnel. Special coils are placed around the pelvic area to capture the magnetic signals, which are then used to generate an image on the computer.
• Contrast agent: If required, a cannula will be inserted into your arm for intravenous contrast administration. You may feel warmth throughout your body, a cooling sensation at the injection site, or a change in taste.
• Noise protection: MRI devices make loud noises during the scan, so you will be provided with ear protection to reduce the noise.
• Communication: You will remain alone in the room but can communicate with the staff via intercom. You will also have a small device to signal if you need to stop the scan. The staff may give you instructions via intercom during the scan, such as asking you to momentarily hold your breath.
• Movement: It is important to stay still during the scan to ensure high-quality images.
• After the scan, the cannula will be removed if a contrast agent was used.

Recovery from pelvic MRI

Most patients experience no need for recovery and can resume normal activities immediately. Some may feel drowsy or dizzy from lying still for the duration of the scan.

If a sedative was taken, wait until its effects wear off before driving. If a contrast agent was used, drink plenty of fluids throughout the day.

If a contrast agent was used, it is recommended to drink larger amounts of fluids throughout the day.

Precautions

Because MRI uses a strong magnetic field, it is essential to inform the radiologic staff about any metal objects in or on your body, including:
cardiac pacemakers, metal clips, removable dental prosthetics, insulin pumps, stents or clips in blood vessels, neurostimulators, artificial heart valves, joint prostheses, cochlear implants, metal fragments or debris, tattoos or permanent makeup containing metals. Some of these items may not be contraindications, but confirmation from the operator is required.

If intravenous contrast is indicated, inform the staff of any kidney-related health issues.

Also, notify the staff if you cannot lie still for an extended period.

For a better patient experience:

• Comfortable MRI room design
• Soft patient support during the scan
• Noise reduction with special patient ear protection
• Audio instructions and support throughout the scan

Technical specifications:

• Tunnel diameter: 70 cm
• Tunnel length: 1.37 m

The price of a pelvic MRI

For current pricing, please refer to our latest price list.

Service Location

Documents for patients

• Upute za pacijente za MR snimanje
• Pomoć pacijentima za opuštanje tijekom magnetske rezonance u uskom prostoru

 

Most frequently asked questions: