Imaging Technologies In Pelvic Pain and Related Conditions
Created: 7/23/2020
This is a very basic list of stuff you might encounter in the early stages of investigating pelvic, or other kinds, of pain. These days there’s increasingly specialized variations of each of these technologies, and with better computer processing, they’re constantly getting more effective and safer.
Ultrasound is an extremely safe technology that shoots mechanical pulses, high pitched sound beyond our hearing range, into your body and records the reflection bouncing off your tissues. Obviously, they shoot this stuff not just at pregnant women, but at the fetus itself. It’s very cheap and safe. Always pick this over radiation if there’s a choice. It gives a pretty flat, fuzzy image to people to work with, but it can’t see beyond superficial tissues. Ultrasound is perfect for looking at testicles or kidneys for cancer, and at superficial muscles and tendons for tears. It’s also useful in guiding injections towards specific nerves — it can show you a pulsating vein, and veins often run alongside key nerves.
X-Ray is radiation that a lot of people would’ve seen at the dentist or if they ever hurt themselves playing sports. It’s basically great for bones (radiography). For example, to see if they’re cracked. Or sometimes to help guide a needle for injections as mentioned earlier (fluoroscopy). This is radiation. One or two of these in a year is not the worst thing in the world. It’s comparable to flying a few times, depending on the size of the area imaged.
A CT scan, computed tomography, is essentially an extended version of X-rays. It uses many X-ray images in one procedure, to snap cross sections (slices) of your body, so it is the most dangerous. An ER doctor at UCSF once told me putting me through a scan to check my appendix would give me a 1 in 500 chance of developing a cancer in the imaged area down the line, and advised me, correctly, against getting imaging, based on my symptoms. Still, CT scans are a very powerful tool to look at certain kinds of tissues.
The newest common technology is magnetic resonance imaging, MRI. This is sort of comparable in power to CT scans, but they’re much safer. Even though they use magnetic radiation, it’s not “ionizing”, which means it won’t cause mutations inside your cells and so, potentially, cancer. MRI is great. Other than the contrast sometimes used, which is injected into you, and metal implants in your body, the safety concerns are usually negligible.
MRI and CT scans cut deep through your body, but tend to each do better on different kinds of tissues.
Finally, there’s increasingly sophisticated variations on all those, many under active research and development. Just one example: The Neuroquant brain scan is an example. Neuroquant is analysis on top of regular MRI imaging that can show how the volumes of the various components of your brain differ from healthy brains and potentially alert you to things like dementia or traumatic brain injury.
