What is the role of MRI in the workup of endometriosis?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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Magnetic resonance imaging (MRI) offers a superior combination of 3-dimensional (3-D) imaging with high-resolution special and temporal resolution, low observer dependency, no radiation exposure, and none of the risks associated with iodinated contrast agents.

With dynamic contrast-enhanced MRI, dynamic changes in MR signal intensity in selected tissues can be detected. Some of the newer generation contrast agents can be loaded with specific antibodies that allow for targeted imaging.

MRI is helpful in detecting rectal involvement [54] and has been shown to accurately detect rectovaginal endometriosis and cul-de-sac obliteration in more than 90% of cases when ultrasonographic gel was inserted in the vagina and rectum. [55] MRI has a higher sensitivity for detecting pelvic masses than ultrasonography but is limited in identifying diffuse pelvic endometriosis.

However, the cost-effectiveness of this MRI for endometriosis has yet to be justified for use as a routine tool.

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