An MRI of the uterus is an MRI of the female pelvis (a pelvic MRI). A pelvic MRI shows your cervix, ovaries, fallopian tubes, and rectum in addition to your uterus.
Your medical provider may have ordered a pelvic MRI. Or, you yourself may be concerned about the health of your uterus. In either case, getting a pelvic MRI can tell you much about your overall health.
Why Might a Clinician Recommend an MRI of Your Uterus?
There are many reasons a gynecologist or other medical provider might refer you for a uterine MRI scan1. Referrals could be prompted by the finding of a pelvic mass during a physical exam or by abnormal bleeding.
Here are other reasons your provider might order a scan:
Endometriosis and Adenomyosis
Both endometriosis and adenomyosis refer to disorders in which uterine tissue grows in places it shouldn’t. The difference lies in the location.
In endometriosis, uterine tissue grows outside the uterus2. It commonly involves the ovaries and fallopian tubes and is often accompanied by pelvic pain and an irregular menstrual cycle.
In adenomyosis, uterine tissue grows into the muscle of the uterus3. Both endometriosis and adenomyosis can have a detrimental impact on pregnancy, including infertility4,5.
MR imaging has been used as a non-invasive imaging method for diagnosing adenomyosis6. MRI scans have also been useful for diagnosing both anterior (near the front) and posterior (near the back) endometriosis, helping clinicians detect the presence of endometriosis in all areas of the body7,8.
Cancer Detection, Characterization, and Staging
In oncology, MR imaging has been used for characterization, treatment monitoring, and disease recurrence9.
If uterine, cervical, or endometrial cancer is suspected, one of the first steps is to determine the stage of cancer (also known as cancer staging). This is where a doctor helps you assess exactly where the cancer is located, how big the tumors are, and how much they have progressed. They’ll let you know if you need to be concerned and will help you figure out the best plan for keeping an eye on any changes.
Another area where research has found MRIs to be useful is in investigating ovarian cysts.
A study published in Clinical and Experimental Obstetrics and Gynecology reported that about 7 percent of women worldwide have an ovarian cyst at some point in their lives. In the U.S., that number increases to 18 percent in postmenopausal women10.
While learning that you have an ovarian cyst can be scary, it’s not necessarily a reason to worry. Cysts are fairly common and may not be related to cancer. Your clinician may order an MRI to make sure that a cyst on your ovary is indeed benign.
Visualization and Detection: The Benefits of a Pelvic MRI
The biggest benefit of doing an MRI of the pelvis is getting information. Without information, making treatment decisions is difficult and could be ineffective.
Visualization
If a gynecologist or another health care practitioner has recommended you for a pelvic MRI, they’re likely looking for more information and visualization. The scan helps provide a more informed picture of your situation and helps your medical practitioner decide the next course of action. In other words, MRIs are often useful diagnostic and monitoring tools.
Detection
When used as a preventive measure, regular pelvic screenings help monitor your body over time and detect any malignancies or abnormalities early11. Having a baseline understanding of your pelvic health and tracking any changes can be significant and sometimes lifesaving.
Can a Pelvic MRI Diagnose Uterine Cancer?
The only way to definitively diagnose cancer is through biopsy and tumor testing.
MRIs can, however, play a role in treating cancer. An article published in RadioGraphics reviewed the updates on staging put forth by the International Federation of Gynecology and Obstetrics, also known as FIGO12,13. FIGO now includes MRI as an essential part of the staging of endometrial cancer (a type of uterine cancer). According to the article, this type of imaging can accurately visualize the depth of myometrial invasion, which correlates with tumor grade, lymph node metastasis, and overall patient survival.
This data is vital not only to initial evaluation but also to evaluating treatment effectiveness and monitoring recurrence.
Should I Get a Preventive MRI?
Screening tests are used to detect cancer before symptoms appear. This is important because early detection of cancer increases survival rates.
In fact, the World Health Organization has shown that cervical cancer screening, including Pap smears, has reduced cervical cancer mortality by 80 percent or more among screened women in developed countries14.
According to the National Cancer Institute, cervical cancer represents 0.7 percent of all new cancers in the United States15.
Uterine cancer, on the other hand, represents 2.2 percent of all new cancer cases, making endometrial carcinoma, cancer of the lining of the uterus, the most common gynecologic malignancy16.
Fortunately, regular pelvic screenings can serve as an early detection tool for cancers and abnormalities. If used properly, they have the potential to reduce mortality rates.
How Is the Test Performed?
An MRI is a painless and fairly simple test from the patient’s perspective. The procedure can take anywhere from 30 minutes to two hours.
Preparing for a Pelvic MRI
Preparing for a pelvic MRI is relatively easy.
A radiology technician will ask you about any preexisting conditions or implants and may discuss any feelings of nervousness about being in tight spaces. If you have metal implants, you may not be a candidate for an MRI. While you may have already discussed this with another medical provider, radiology technicians always do a second check.
Because the MRI machine contains strong magnets, you’ll be asked to remove all metal objects, including eyeglasses, jewelry, hearing aids, and removable dental work. You’ll wear a gown during the scan.
During the Scan
The most difficult part is holding still.
During an MRI, you’ll lie flat on a table that will slide into the MRI machine. You’ll experience airflow and noises while inside the machine. While you will be alone in the room, the radiographer operating the machine will be able to see you and communicate with you the entire time.
You won’t experience any pain during the scan, although you may be sore from lying in one place.
Does Your Whole Body Go In For a Pelvic MRI?
Yes, in a conventional MRI scanner, most of your body will likely be inside the machine for proper imaging of the pelvis17. This is because the pelvis is located in the middle of the body, and the scanner needs to capture images of this region accurately.
Some patients might experience claustrophobia. However, a radiologist will be in contact the entire time if you need to stop or require reassurance.
What Does a Pelvic MRI with Contrast Show?
A pelvic MRI with contrast provides detailed images of the pelvic region, offering enhanced visualization of structures and potential abnormalities. Using contrast agents, typically gadolinium, allows for better differentiation and characterization of tissues and lesions.
Enhanced Visualization
- Intratumoral architecture: Contrast-enhanced images improve the definition of internal structures within tumors, aiding in determining malignancy with 95 percent accuracy of adnexal masses (growths that develop near the uterus)18.
- Tumor borders: The contrast agent helps delineate the boundaries of tumors more clearly, which is crucial for staging and treatment planning.
- Viable tumor tissue: Contrast enhancement helps distinguish between viable tumor tissue and other components like fluid or necrotic areas.
Gynecological Issues
Pelvic MRI with contrast can differentiate between benign and malignant ovarian masses, can assess the depth of myometrial invasion in endometrial cancer, and has improved the evaluation of parametrial and organ invasion18.
Urological Concerns
Pelvic MRI can identify bladder abnormalities and prostate issues, including cancer and benign prostate hyperplasia19.
Other Pelvic Structures
Pelvic MRI can improve visualization of blood vessels, lymph nodes, soft tissues (including pelvic floor muscles), and colorectal abnormalities20.
Diagnostic Capabilities
Contrast-enhanced pelvic MRI is particularly useful for:
- Staging pelvic cancers, including cervical, endometrial, and ovarian cancers.
- Evaluation of complex adnexal masses17,18.
- Assessment of endometriosis and adenomyosis17,18.
- Detection and characterization of fibroids.
- Investigation of congenital anomalies of the reproductive organs.
While contrast-enhanced MRI provides valuable additional information, it may not always be necessary. The decision to use contrast is based on the specific clinical issue and the radiologist’s assessment of the initial non-contrast images.
After the Scan
Once the scan is over, you can go back to your normal day.
You don’t need anyone to pick you up, and there is no downtime after the exam is complete. Simply get dressed and head out the door.
What Are The Potential Risks of a Uterus MRI?
While uterus MRI is generally considered safe, there are some potential risks to be aware of:
General MRI Risks
Metal Interactions: The strong magnetic field can interact with metal objects in or on the body, potentially causing injury or image distortion21.
Claustrophobia: Some patients may experience anxiety or panic in the enclosed MRI machine.
Loud noises: MRIs produce loud noises that can be uncomfortable. However, you will be provided with hearing protection while you undergo the MRI.
Contrast-Related Risks
Allergic Reactions: Though rare, some individuals may have an allergic reaction to the gadolinium contrast agent used in some MRI scans22.
Nephrogenic systemic fibrosis: Patients with severe kidney disease may be at risk of this rare but serious condition when exposed to gadolinium contrast1.
Pregnancy Considerations
While MRI is generally considered safe during pregnancy, caution is advised:
First trimester scans: MRI is typically avoided in the first trimester unless absolutely necessary23.
Contrast use: Gadolinium contrast is usually not used during pregnancy unless the benefits clearly outweigh the potential risks24.
Other Potential Risks
Heating effects: In rare cases, the radio waves used in MRI can cause slight heating of the body.
Implant complications: Certain medical implants may malfunction or heat up during an MRI.
It should be noted that serious complications from uterus MRI are extremely rare, and the benefits of the procedure often outweigh the potential risks for most patients.
How Do I Interpret My Results?
After an MRI, a radiologist reviews and interprets the image findings and generates an official radiology report that consists of a written analysis of your imaging study. The report is then transmitted to your medical provider, who will follow up and walk you through your results and any next steps they recommend.
How Much Does a Pelvic MRI Cost?
The cost of a normal uterus MRI can vary depending on several factors.
Without insurance, the cost of a pelvic MRI (without contrast) can range from $550 - $1,450, depending on the state you are in25. Adding contrast on top of this will likely cost more.
At Ezra, you can get a Full-Body Flash for $1,495, which includes not just the pelvis but also the head, neck, and abdomen to scan for abnormalities. Ezra also takes FSA/HSA dollars and provides flexible payment plans if needed.
Learn More About Your Uterine Health With an ezra Screening
Traditionally, doctors tend to take action once you have symptoms. This approach can allow cancers to grow undetected. Routine MRIs and other screenings not only have the ability to give you peace of mind but can potentially provide lifesaving information.
Ezra’s full-body screenings provide additional information about your overall health so that you can take control of your health now.
If you feel ready to take control of your uterine health, book an ezra screening now.
Do you know someone who could benefit from a full-body screening?
Gift a scan to someone special.
