MRI of the genitourinary system
To detect the pathology of the urogenital system in men, and in women, MRI is one of the main radiological methods. In the diagnosis of diseases of the small pelvis, this method has several advantages: high diagnostic accuracy in the detection of early stages of pathological process, non-invasive, painless, no harm to the health of the patient.
The scope of the survey
In women, MRI allows us to examine the bladder, the vagina, the cervix and body of the uterus, ovaries, fallopian tubes, blood vessels, lymph nodes, soft tissue of the pelvis, the lower parts of the colon, part of the lumbar spine, sacrum and coccyx.
During examination of small pelvis in males are visualized: the bladder, urethra, distal ureters, seminal vesicles, and ejaculatory ducts, prostate gland, blood vessels (arteries and veins), lymph nodes, soft tissue, fiber, distal sections of the intestine and the lower segment of the spine (part of the lumbar, sacral, and coccygeal departments).
Indications for Mr-research of the genitourinary system
- Suspicion on the tumor process bladder, prostate in men, lower intestine, genitals in women.
- Determination of the nature of tumor (benign or malignant).
- Traumatic injuries of the pelvis
- A suspected inflammatory process in the pelvis.
- Extensive endometriosis in women.
- Vices and anomalies of the urogenital area.
- A study to assess the postoperative dynamics.
- Pain in the pelvis of unknown origin.
- Violation of urination in men.
- The suspicion of a metastatic process in the pelvis, the sacrum and the coccyx.
In some cases, diagnosis is contraindicated
- Severe claustrophobia (fear of closed spaces).
- Ferromagnetic hemostatic clips (e.g., brain vessels).
- The presence of metallic foreign bodies in the body of the patient (surgical plates, screws, clips, etc.).
Preparing for the Mr-procedure
To examination of the genitourinary system to be effective, requires special training of the patient to the MRI. It consists in the adequate filling of the bladder, the limitation of the rough and increase flatulence food for two days prior to the study, if necessary – perform cleansing enemas to improve visualisation of the bowel loops.
To relieve spasm of the uterus in women, increased tonus of intestinal loops to perform magnetic resonance imaging (20-30 minutes) you must perform an intramuscular injection of antispasmodic (drotaverine in 2 ml volume) or take it orally (3 tablets).
Women preferably carried out magnetic resonance imaging on day 5-7 of the menstrual cycle. Men to examine at any period. Don’t forget to bring the data from previous Mr-studies, statements, the results of other radiological methods (e.g., ultrasound).
Emergency MRI of the urogenital sphere is carried out without special training.
The features of the
The average study lasts 15-30 minutes. When using contrast duration increases. Before the test the patient takes off jewelry that might interfere with the MRI, as well as clothing with metal elements.
For examination of the small pelvis, there is a specific coil that is attached to the area of study. The patient briefly explain the procedure. It is important during the Mr-scan to lie still to get a quality image.
Small children when the need for MRI in most cases, using anesthesia, to obtain Mr-tomograms of good quality, free of motion artifacts. Patients with severe pain it is recommended to perform anesthesia before an MRI to alleviate the condition.
In some cases, required in addition to standard Mr-study time-contrast enhancement. In the first place – it is necessary to estimate the prevalence of malignant tumors and in the differential diagnosis of volumetric processes.
In MRI-examination of the genitourinary system used a gadolinium contrast agent (Magnevist, dotarem, gadovist, etc.). Feature of these drugs is harmless to patients and very rare allergic reactions to intravenous. The amount of contrast is calculated individually and depends on the body weight of the patient. A contraindication to their use is intolerance, renal insufficiency, a very serious condition of the patient, in women – pregnancy, breast-feeding.
In conclusion, it should be noted that MRI in the diagnosis of pathology of the genitourinary system not only has a number of advantages compared to other radiation imaging studies, but also the opportunity to hold such invasive and painful procedures as in hystero — and laparoscopy.