Coccyx MRI is a non-invasive method of layer-by-layer scanning of the lower spine using an electromagnetic field and subsequent fixation of the obtained data with special equipment. It is used for visualization of the coccyx bones and surrounding soft tissues, nerves, blood vessels. It is used to diagnose inflammatory and destructive changes in the bones and tissues surrounding the coccygeal bones. It is prescribed for the detection of fractures and post-traumatic pathologies, structural anomalies, various kinds of volumetric formations. It is possible to conduct coccyx MRI with or without contrast.
Coccyx MRI is usually prescribed based on the results of radiography of the coccygeal zone in cases where it is necessary to clarify the localization of the pathological process or to identify a pathological focus that was not detected during previous studies. The technique is also used in oncology in preparation for operations, to exclude tumor metastasis and control the effectiveness of treatment. Congenital pathologies (cyst, epithelial coccygeal course) are confirmed by MRI diagnostics.
Indications for coccyx MRI are patient complaints of pain in the coccyx area in the absence of an obvious organic cause (coccygodynia). Discomfort and pain during urination and defecation may indicate bulky formations, inflammatory processes in the coccyx bones, pararectal tissue, etc., therefore, in such cases, MRI is included in the diagnostic examination complex. The technique is used to identify developmental anomalies, destructive processes of post-traumatic and other genesis in the lower spine. When planning an operation, coccyx MRI is prescribed for a detailed study of the structure of bones, the course of blood vessels and nerves.
Common contraindications to MRI are the presence of cardio and neurostimulators in the patient’s body, metal pins (except titanium), some vascular stents and terminals, dental prostheses. Any metal objects falling into the field of the tomograph can heat up and shift, which reduces the reliability of the diagnostic procedure and in some cases may pose a danger to the life of the subject. Conducting a study is not possible with epilepsy and mental disorders, when there is a risk of developing psychomotor agitation or seizures. According to vital indications, MRI in such cases is performed under general anesthesia. During pregnancy, examination is also not recommended, although in the second and third trimester the issue is resolved individually.
Coccyx MRI with contrast is not prescribed when an allergy to a contrast agent (gadolinium) is detected. If the subject has allergic reactions to other substances, the procedure can be carried out with preliminary drug preparation (antihistamines, corticosteroids). The use of contrast in women during lactation is accompanied by the cancellation of breastfeeding for the next 24-48 hours after the procedure, which is associated with the possibility of the drug entering breast milk. A contrast study is performed with caution in patients with chronic renal and hepatic insufficiency. For persons weighing more than 120-140 kg, MRI is not possible due to technical limitations (inconsistency of body weight with the lifting capacity of the equipment).
An allergological history is found out in advance, it is possible to conduct skin tests with the contrast agent used. The need for contrast also implies an assessment of the condition of the liver and kidneys. If severe renal or hepatic insufficiency is detected, it is preferable to prescribe coccyx MRI without using contrast, or to choose another diagnostic method. On the eve and immediately before the procedure, special preparation is not required. When using contrast, the study is performed on an empty stomach, an intravenous catheter is usually installed 15-20 minutes before the start of the examination.
Methodology of conducting
The tomograph is a massive tube, in the center of which a couch is placed. The patient lies down on the couch, usually face down, and during the scan is located in the center of the device. Contrast injection is carried out by jet or drip in about 20 minutes to start scanning. If the substance enters the body, the subject may feel a fever in the body for several minutes. In general, gadolinium chelate compounds rarely cause allergic reactions, but if signs of edema or difficulty breathing appear, the patient should immediately inform the doctor. In the room there is a set of medicines necessary for the relief of urgent conditions.
The duration of the study ranges from 15 to 40 minutes and depends on the need for contrast. Possible complications may be associated with renal and hepatic insufficiency, as well as due to the presence of metal objects in the patient’s body. The results of coccyx MRI are prepared within a few hours, usually up to a day. The patient can receive the data in printed form, if desired, the information is recorded on a digital medium. With the interpretation of the images, the examinee turns to the attending physician.