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Imaging in endometriosis

Clinical Radiology, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK

• Laparoscopy is the gold standard for diagnosis and staging of endometriosis.
  
• Characteristically, endometriomas have a uniform low-echo content on ultrasound but appearances can be very diverse.
  
• The ability of MRI to characterize the products of haemorrhage make it the test of choice for problem solving and for the identification of extra-ovarian deposits.
  
• MRI is the most reliable non-invasive tool for evaluation of disease distribution and complications prior to surgery but endocavitary ultrasound plays a complementary role.
  
• MRI is able to identify malignant change in endometriosis.
  

In this article, we present the imaging features of endometriosis on ultrasound and magnetic resonance imaging (MRI). We give particular emphasis to the manifestations of different sites of pelvic involvement on MRI. Complications such as renal tract obstruction and associated malignancy are also illustrated.