Pelvic imaging allows the radiologist to analyse the organs in the small pelvis.
PELVIAN ULTRASOUND
This imaging technique makes it possible to visualize the uterus and its mucosa (endometrium), ovaries, fallopian tubes, as well as the bladder and urinary tract. It can be performed endocavitary (vaginal) or externally (abdominal).
How to prepare for the exam: The patient must come to the examination with a full bladder, in order to allow the radiologist a better visualization of the area.
How the exam works: The examination can last from 10 to 30 minutes, depending on the number of organs that need to be examined. The ultrasound probe is covered with hypoallergenic gel and then applied to the pelvic area, thus obtaining images thanks to ultrasound reflecting on the walls of the organs.
What are the advantages of such an examination: This examination is done without the use of X-rays, since it uses only ultrasound from the ultrasound probe. It therefore poses no danger to the woman or her baby in the case of fetal imaging.
MRI PELVIAN
Pelvic MRI is usually indicated in addition to an ultrasound examination, a first-line examination. This type of examination is usually performed in case of gynecological diseases, such as endometriosis, fibroids or in the characterization of ovarian lesions. Pelvic MRI remains the examination of choice in gynecological tumor assessments.
How to prepare for the exam : The patient should be fasting 3 hours before a pelvic MRI. No other type of preparation is indicated for this type of management.
How the exam is done: The pelvic MRI lasts between 30 and 45 minutes. The patient's lower body, which is lying on her back, is in the MRI tube, while the upper body is outside, decreasing the risk of a possible feeling of claustrophobia being felt. It is possible for the vagina and rectum to be clouded by gel, especially when looking for endometriosis or the presence of vaginal or cervical tumors. An intramuscular injection of an antiperistaltic is performed to decrease bowel movements and improve image quality.
What are the advantages of such an examination : This type of examination is non-irradiating and non-invasive for the patient. The images offer visualization thanks to different cuts in space, as well as a high precision in their quality.
HYSTEROGRAPHY
The radiologist performs hysterography when he wants to visualize the uterus, cervix or fallopian tubes. Generally, patients have hysterography during fertility disorders. This imaging method requires injection of contrast medium and is performed using X-rays. However, it does not allow the observation of the ovaries.
How to prepare for the exam : It is recommended to perform a hysterography between the 8th and 12th day of the menstrual cycle.
How the exam takes place: Thirty minutes are required for this support. Using the speculum inserted into the vagina, contrast medium is injected through a probe into the patient's uterus and fallopian tubes. Following hysterography and in case of an abnormal reaction, such as a fever flare-up or, for example, bleeding, please notify your doctor or gynaecologist.
What are the advantages of such an examination : This type of examination makes it possible to check the degree of permeability of the fallopian tubes, as well as the good performance of the uterine and peritoneal cavities.
UTERINE FIBROID EMBOLLIZATION
Uterine fibroids are tumors in the lining of the uterus, affecting a high percentage of women in their thirties. Fibroids are not necessarily symptomatic, but can create pain, bleeding or urinary difficulties.
Initial management consists of hormone administration or anti-inflammatory therapy. When these are not sufficient and for the rest of the patient's care, embolization is a minimally invasive method performed under local anesthesia, which represents an alternative to surgery. The interventional radiologist conducts the procedure by injecting small synthetic particles inside the arteries of the uterus, through a very thin catheter inserted into the artery of the groin fold. These particles clog the artery and thus block the vascularization of fibroids.
PELVIC CONGESTION TREATMENT
Pelvic congestion syndrome is chronic and represented by an excess of blood in the pelvic veins, which creates abdominal pain. This syndrome usually affects women between the ages of 30 and 50. It is usually thanks to an ultrasound that this pathology is detected.
Initially, management is done through the administration of anti-inflammatory drugs or medication, to reduce pain. If this first treatment fails, the interventional radiologist can intervene by inserting a catheter into the patient's thigh to reach the dilated veins of the pelvis. The injection of a product creating an embolization is then done by the radiologist, blocking blood flow in this part of the body and thus reducing pain.