Pelvis MRI in Dehradun gynaecological & pelvic imaging

What a pelvis MRI shows

Ultrasound remains the correct first test for the female pelvis. It is quick, inexpensive, needs no preparation and answers most questions. MRI comes in when the answer matters more than the convenience: when the exact number, size and position of fibroids will determine which operation is offered; when deep endometriosis is suspected and its extent needs mapping before surgery; when an ovarian mass has features that could be benign or malignant and the distinction changes who operates and where.

MRI's advantage here is the same as everywhere else — soft-tissue contrast. It can distinguish the three layers of the uterine wall, which is what makes adenomyosis diagnosable. Ultrasound cannot reliably do that.

Why your doctor ordered a pelvis MRI

Fibroids being considered for treatment

Fibroids are common and most need nothing done. When treatment is being considered, the decision between hysteroscopic resection, myomectomy, embolisation and hysterectomy depends on exactly how many there are, how large, and precisely where each sits relative to the cavity and the wall. MRI provides that map; ultrasound often under-counts fibroids in a bulky uterus.

Suspected adenomyosis

Heavy, painful periods with a bulky uterus and no discrete fibroid suggest adenomyosis — endometrial tissue within the muscle of the uterine wall. MRI diagnoses it by showing thickening of the junctional zone, and it is the most reliable non-surgical way to make the diagnosis.

Suspected deep endometriosis

Endometriosis outside the ovary — on the uterosacral ligaments, the rectovaginal septum, the bowel or the bladder — is difficult to see on ultrasound and is frequently missed for years. MRI maps its distribution and depth, which is what a surgical team needs before operating.

Characterising an ovarian mass

Most ovarian cysts are simple and harmless. Some have solid components, thick septations or unusual contents. MRI characterises these far better than ultrasound, identifying fat in a dermoid, blood in an endometrioma, and the enhancing solid tissue that raises concern.

Staging a known gynaecological cancer

For cervical and endometrial cancer, MRI is the standard staging study. It shows depth of invasion into the uterine wall and whether disease has reached the cervix, parametrium or pelvic side wall — the findings that determine whether treatment is surgical or primary chemoradiation.

Unexplained chronic pelvic pain

When pain has persisted for months and ultrasound and examination are unrevealing, MRI covers everything at once: gynaecological structures, bowel, bladder, pelvic floor, hip joints and sacroiliac joints. It sometimes finds a cause in an entirely different system from the one being investigated.

Fibroids, adenomyosis and endometriosis

Non-gynaecological pelvic MRI

The pelvis is not only a gynaecological region, and several of the commonest pelvic MRI requests have nothing to do with the uterus or ovaries.

• Perianal fistula. MRI is the definitive study, mapping the fistula track relative to the anal sphincters. Because continence depends on the sphincter, a surgeon needs that map before operating. This is one of the highest-value pelvic MRIs there is.
• Rectal cancer staging. MRI shows depth of invasion, the relationship to the mesorectal fascia, and involved lymph nodes — the findings that decide whether chemoradiation is given before surgery.
• Sacroiliac joints. In suspected axial spondyloarthritis, MRI shows active inflammation in the joints years before X-ray shows structural damage. This is often the study that confirms the diagnosis in a young person with inflammatory back pain.
• Pelvic floor and prolapse. Dynamic sequences taken during straining demonstrate descent of the bladder, uterus and rectum.
• Hip and bony pelvis. Stress fracture of the sacrum or pubic rami, and avascular necrosis of the femoral heads, both present as pelvic pain with normal radiographs.

When contrast is needed

Gadolinium contrast is added when the question involves characterising a mass or assessing activity: an ovarian lesion with solid components, staging of a known cancer, an abscess or a complex fistula, and cases where fibroid viability needs assessing after embolisation.

Contrast is normally avoided in pregnancy. Kidney function is checked before it is given. Tell us if you are or might be pregnant, if you are breastfeeding, or if you have had a reaction to any contrast agent before.

Preparing for your pelvis MRI in Dehradun

• Bladder. Many pelvic protocols want a comfortably full — not uncomfortably full — bladder, because it lifts bowel out of the pelvis and improves the images. Others want it empty. We will tell you which when you book, so please ask rather than guess.
• Light fast. If contrast is planned, four hours without food. Water is usually allowed.
• Cycle timing. Tell us the first day of your last period. Some studies are scheduled around it.
• Bring prior imaging and reports. The ultrasound that led to this scan, previous operation notes, and any earlier MRI of the pelvis.
• Coil or device. An intrauterine device is not a contraindication to MRI, but tell us it is there. Declare all implants, including any metal from previous pelvic or hip surgery.
• Anti-peristaltic injection. Some protocols use a small injection to quieten bowel movement, which sharpens the images considerably. You will be told if this applies.

What a pelvis MRI feels like

You lie on your back with a flexible coil placed over your lower abdomen and pelvis. You go into the bore head first and most of your body will be inside the scanner, so tell us in advance if you are claustrophobic — knowing beforehand allows the study to be planned rather than abandoned halfway through.

The scan is not painful and nothing is inserted for a standard pelvic MRI. You are given earplugs or headphones for the noise and a squeeze-ball that stops everything the moment you press it. The technologist speaks to you between sequences.

The main discomfort people report is lying still for forty minutes with a full bladder. If it becomes genuinely uncomfortable, say so — it is better to pause than to move during a sequence.

Privacy, dignity and who is in the room

You change in a private cubicle and are covered throughout. Nothing is inserted for a standard pelvic study. If a specialised protocol does require anything beyond lying on the table, it will be explained fully and consented before you go into the room, not after. You may bring a relative with you, and they can usually wait immediately outside the scanner room.

Pelvis MRI cost in Dehradun

Which parts of Dehradun we cover

• Rajpur Road
• Dalanwala
• Clement Town
• Prem Nagar
• Vasant Vihar
• Jakhan
• Sahastradhara Road
• Race Course
• Patel Nagar
• GMS Road
• Ballupur
• Kaulagarh
• Doiwala
• Selaqui
• ISBT Dehradun
• Mussoorie
• Rishikesh
• Haridwar
• Vikasnagar

Common reference points patients use when giving directions: Clock Tower, Doon Hospital, the ISBT, Graphic Era, Max Super Speciality Hospital and Pacific Mall. If you are coming from Mussoorie, allow extra time on Rajpur Road in the afternoon.

Pelvis MRI in Dehradun: frequently asked questions