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Pelvis MRI scan
Definition
A pelvis MRI (magnetic resonance imaging) scan is a imaging test that uses powerful magnets and radio waves to create pictures of the area between the hip bones. This part of the body is called the pelvic area.
The pelvic area contains the reproductive organs.
- In women, it includes the womb (uterus), cervix, ovaries, and fallopian tubes.
- In men, it includes the prostate gland and testicles.
An MRI does not use radiation. Single MRI images are called slices. The images can be stored on a computer or printed on film. One exam produces dozens or sometimes hundreds of images.
Alternative Names
MRI - pelvis; MRI - hips; Pelvic MRI with prostate probe; Magnetic resonance imaging - pelvis
How the Test is Performed
You may be asked to wear a hospital gown or clothing without metal fasteners (such as sweatpants and a t-shirt). Certain types of metal can cause inaccurate images.
You will lie on your back on a narrow table, which slides into the middle of the MRI machine.
Small devices, called coils, may be placed around the hip area. These devices help send and receive the radio waves, and improve the quality of the images. If pictures of the prostate and rectum are needed, a small coil will be placed into your rectum. This coil must stay in place for about 30 minutes while the images are taken.
Some exams require a special dye (contrast). The dye is usually given before the test through a vein (IV) in your hand or forearm. The dye helps the radiologist see certain areas more clearly.
During the MRI, the person who operates the machine will watch you from another room. The test most often lasts 30-60 minutes, but may take longer.
How to Prepare for the Test
You may be asked not to eat or drink anything for 4 - 6 hours before the scan.
Tell your doctor if you are afraid of close spaces (have claustrophobia). You may be given a medicine to help you feel sleepy and less anxious, or your doctor may suggest an "open" MRI, in which the machine is not as close to the body.
Before the test, tell your health care provider if you have:
- Brain aneurysm clips
- Certain types of artificial heart valves
- Heart defibrillator or pacemaker
- Inner ear (cochlear) implants
- Kidney disease or dialysis (you may not be able to receive contrast)
- Recently placed artificial joints
- Certain types of vascular stents
- Worked with sheet metal in the past (you may need tests to check for metal pieces in your eyes)
Because the MRI contains strong magnets, metal objects are not allowed into the room with the MRI scanner:
- Pens, pocketknives, and eyeglasses may fly across the room.
- Items such as jewelry, watches, credit cards, and hearing aids can be damaged.
- Pins, hairpins, metal zippers, and similar metallic items can distort the images.
- Removable dental work should be taken out just before the scan.
How the Test Will Feel
An MRI exam causes no pain. If you have difficulty lying still or are very nervous, you may be given a medicine to relax you. Too much movement can blur MRI images and cause errors.
The table may be hard or cold, but you can request a blanket or pillow. The machine produces loud thumping and humming noises when turned on. You can wear ear plugs to help reduce the noise.
An intercom in the room allows you to speak to someone at any time. Some MRIs have televisions and special headphones that you can use to help the time pass.
There is no recovery time, unless you were given a medicine to relax. After an MRI scan, you can resume your normal diet, activity, and medications.
Why the Test is Performed
This test may be done if a female has any of the following signs or symptoms:
- Abnormal vaginal bleeding
- A mass in the pelvis (felt during a pelvic exam or seenon another imaging test)
- A pelvic mass that occurs during pregnancy
- Endometriosis (usually only done after ultrasound)
- Pain in the lower belly (abdominal) area
- Unexplained infertility (usually only done after ultrasound)
- Unexplained pelvic pain (usually only done after ultrasound)
This test may be done if a male has any of the following signs or symptoms:
- Lumps or swelling in the testicles or scrotum
- Undescended testicle (unable to be seen using ultrasound)
- Unexplained pelvic or lower abdominal pain
- Unexplained urination problems, including trouble starting or stopping urinating
A pelvic MRI may be done in both males and females who have:
- Abnormal findings on an x-ray of the pelvis
- Birth defects of the hips
- Injury or trauma to the hip area
- Unexplained hip pain
A pelvic MRI is also frequently done to see if certain cancers have spread to other areas of the body. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future. A pelvic MRI may be used to help stage cervical, uterine, bladder, rectal, prostate and testicular cancers.
Normal Results
A normal result means your pelvic area appears normal.
What Abnormal Results Mean
Abnormal results in a woman may be due to:
- Adenomyosis
- Bladder cancer
- Cancer of the renal pelvis or ureters that has spread from the kidneys
- Cervical cancer
- Colorectal cancer
- Congenital defect of the reproductive organs
- Endometrial cancer
- Endometriosis
- Ovarian cancer
- Ovarian growths
- Problem with the structure of the reproductive organs, such as the fallopian tubes
- Uterine fibroids
Abnormal results in a man may be due to:
- Bladder cancer
- Cancer of the renal pelvis or ureters that has spread from the kidneys
- Colorectal cancer
- Prostate cancer
- Testicular cancer
Abnormal results in both males and females may be due to:
- Avascular necrosis
- Birth defects of the hip joint
- Bone tumor
- Hip fracture
- Osteoarthritis
- Osteomyelitis
Consult your health care provider with any questions and concerns.
Risks
MRI contains no radiation. To date, no side effects from the magnetic fields and radio waves have been reported.
The most common type of contrast (dye) used is gadolinium. It is very safe. Allergic reactions to the substance rarely occur. However, gadolinium can be harmful to patients with kidney problems who require dialysis. If you have kidney problems, please tell your health care provider before the test
The strong magnetic fields created during an MRI can cause heart pacemakers and other implants to not work as well. It can also cause a piece of metal inside your body to move or shift.
Considerations
Tests that may be done instead of a pelvic MRI include:
- CT scan of the pelvic area
- Vaginal ultrasound (in women)
- X-ray of the pelvic area
A CT scan may be done in emergency cases, since it is faster and usually available right in the emergency room.
References
Wilkinson ID, Paley MNJ. Magnetic resonance imaging: basic principles. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 5.
Gjelsteen AC. CT, MRI, PET, PET/CT, and ultrasound in the evaluation of obstetric and gynecologic patients. Surg Clin North Am. April 2008; 88(2): 361-90, vii.
Bohm-Velez M, Fleischer AC, Andreotti RF, Fishman EK, Horrow MM, Hricak H, Thurmond A, Zelop C, Expert Panel on Women's Imaging. Suspected adnexal masses. [online publication]. Reston (VA): American College of Radiology (ACR); 2005. 10 p.
Hricak H, Akin O, Sala E, Fleischer AC, Bohm-Velez M, Fishman EK, Mendelson E, Thurmond A, Goldstein S, Expert Panel on Women's Imaging. Endometrial cancer of the uterus. [online publication]. Reston (VA): American College of Radiology (ACR); 2005. 6 p.
Hricak H, Akin O, Sala E, Fleischer AC, Bohm-Velez M, Fishman EK, Mendelson E, Thurmond A, Goldstein S, Expert Panel on Women's Imaging. Invasive cancer of the cervix. [online publication]. Reston (VA): American College of Radiology (ACR); 2005. 6 p.
Reviewed By: Ken Levin, MD, private practice specializing in Radiology and Nuclear Medicine, Allentown, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
