MRI for Endometriosis: What To Expect, What It Can Show, and What Endometriosis Pictures Look Like

What is endometriosis?

Endometriosis is a chronic (lifelong) condition in which tissue and cells similar to the womb's lining grow in areas and other organs outside the womb, such as the ovaries, fallopian tubes, bowels and bladder. These tissues are affected, just like the womb lining, by hormonal changes during the menstrual cycle, so they can grow, thicken and break down in the same way as the womb lining, causing inflammation and severe pain for some people. 

Endometriosis can affect women of any age, including teenagers, and can cause painful cramping, heavy periods, abdominal or back pain, pain during sex and problems with fertility, among other symptoms. 

If you’re concerned that you are experiencing symptoms that could be endometriosis, you may be wondering if a scan can help to identify the condition and whether an MRI scan is the right option for you. We’ll guide you through everything you need to know, from ultrasound and MRI scans for endometriosis to common and uncommon symptoms of the condition. Plus, discover what to expect from an MRI for endometriosis and what MRI endometriosis pictures look like. 

Should I get an MRI scan for endometriosis?

While endometriosis MRI scans are effective at picking up the condition, your doctor will likely recommend an ultrasound scan for endometriosis first. An ultrasound scan can help rule out or confirm other possible causes of your symptoms, and it’s usually carried out as a transvaginal ultrasound scan. This involves inserting a small ultrasound probe into the vagina to generate images of the reproductive organs. However, in some cases, an external ultrasound of the abdomen (tummy) may be recommended. 

An ultrasound scan can help your doctor identify certain problems that may indicate endometriosis, such as cysts and/or tissues in areas other than the womb lining. 

However, an ultrasound is unlikely to identify smaller areas of endometrial tissues on the surface of an organ. This is why many doctors will recommend an MRI as the next step in diagnosing endometriosis.

Compared to ultrasound, MRI:

• Gives more detailed and clear images of the pelvic area.

• Is more accurate for diagnosing deep and complex endometriosis.

• Is better for seeing endometriosis in hard-to-reach areas inside the pelvis.

• Can find endometriosis in unusual locations that ultrasound might miss.

• Helps doctors plan surgery by showing all the affected areas in detail.

• Provides extra information if an ultrasound is unclear or inconclusive.

• Is helpful in understanding complex or severe symptoms affecting multiple areas.

Endometriosis can cause a wide range of symptoms, making it a complex and often frustrating condition to diagnose. Many women endure years of pain and discomfort before getting a clear answer. Different types of scans can be part of the diagnostic process, helping to identify the condition and provide some much-needed clarity and relief.

If you’re unsure whether to opt for an ultrasound or an MRI scan for endometriosis, our clinicians can help with a one-to-one consultation. Following your consultation, you’re not obliged to book either scan, but you will receive expert advice and guidance from a qualified clinician who can help you understand your options.

Common symptoms of endometriosis

Here are some common symptoms of endometriosis that might lead your doctor to recommend an MRI scan to look for signs of the condition:

• Ongoing discomfort or pain in the pelvic area that doesn't go away and interferes with daily life.

• Intense pain during your period that isn’t relieved by usual methods or treatments.

• Difficulty getting pregnant despite trying for a significant period - this can be a sign of endometriosis affecting your reproductive organs.  

• Pain during sex that feels deep inside the pelvis - this can be a sign of deep infiltrating endometriosis.  

• Severe pain or discomfort when you’re going to the toilet - this can be a sign that endometriosis is affecting your bladder or intestines.

Uncommon symptoms of endometriosis

Less common signs and symptoms of endometriosis that could warrant an MRI scan to look for signs of the condition include:

• Extreme tiredness that doesn’t improve with rest which can sometimes be a result of severe endometriosis.

• Nausea, vomiting, bloating and bleeding from the rectum are less commonly linked to endometriosis but can happen if it affects your bowel.

• Endometriosis can occasionally affect the kidneys or ureters, leading to pain or urinary problems, such as blood in your pee or more frequent urination.

• Some people develop severe acne, suggesting there’s a link between acne and endometriosis.

• Rarely, endometriosis can affect the lungs, causing symptoms such as chest pain or difficulty breathing.

• In very rare cases, endometrial tissue can press on nerves, causing neurological symptoms such as leg pain, numbness, or tingling.

Can an MRI detect endometriosis?

Yes, a pelvic MRI for endometriosis can play a crucial part in forming a diagnosis for endometriosis and managing the condition. Here’s why:

• It’s accurate at diagnosing endometriosis, especially the type that goes deep into tissues, and it is highly reliable in identifying the condition.

• It helps doctors see the full extent of endometriosis before surgery, allowing for better planning of the operation.  

• It provides detailed images of where and how much endometriosis is present, helping doctors understand the impact on nearby organs and tissues.  

• It’s particularly effective at finding deep-infiltrating endometriosis and ruling out other conditions with similar symptoms.  

• It’s helpful in detecting endometriosis in unusual places, such as the bladder or belly button, where other tests might not work as well.  

• It works well with other imaging tests, such as ultrasound, giving doctors a fuller picture of your condition.  

• It’s a valuable, non-invasive option that reduces the need for invasive surgical procedures such as a laparoscopy.

What to expect from an endometriosis MRI procedure

MRI stands for magnetic resonance imaging. It’s a type of scan that creates multiple detailed images of the inside of your pelvis, including soft tissues such as the womb, ovaries, fallopian tubes and bladder. Your radiologist will ask you to lie down on a bed and stay absolutely still. The bed will then pass through a tube-like structure. It can be a bit noisy and distracting, so you may be given headphones. It can take around 40 minutes to complete the scan. 

MRI endometriosis pictures: What do they look like?

On an MRI scan, endometriosis can look like a variety of unusual growths and changes in the pelvic area.  Endometriosis on MRI scans often appears differently from patient to patient, depending on what part or parts of the pelvis are affected by endometrial tissue:

• Peritoneal implants: Small, dark spots scattered along the abdominal walls.

• Adhesions: Dense bands of tissue connecting different pelvic organs, often pulling them out of their regular positions.

• Bladder lesions: Areas of thickening in the bladder wall.

• Endometriomas: Large, dark, round masses, typically near the ovaries, filled with old blood and fluid.

• Kissing ovaries: Ovaries positioned abnormally close together or touching.

• Displaced womb: The womb may sit deeper in the pelvic cavity than normal.

• Elevated vagina: Part of the vagina may appear higher than a typical position.

• Distorted bowel: Unusual bends, curves, or loops in the intestines.

• Thickened pelvic structures: Ligaments, muscles, or tendons within the pelvis may look abnormally bulky.
  

A pelvic MRI for endometriosis, especially deep-infiltrating types, is a key step in diagnosing the condition. An MRI provides accurate and detailed images of endometrial growths and tissues, along with their impact on organs within the pelvis. This noninvasive imaging technique helps doctors understand complex signs and symptoms and plan treatment that can help patients manage their chronic condition. 

Sources:

6 Uncommon or Lesser-Known Symptoms of Endometriosis. (2023). https://www.healthline.com/health/uncommon-symptoms-of-endometriosis

Endometriosis. (2022). https://www.nhs.uk/conditions/endometriosis/

Endometriosis. (2024). https://radiopaedia.org/articles/endometriosis?lang=gb

Foti PV et al. (2018). Endometriosis: clinical features, MR imaging findings and pathologic correlation.https://insightsimaging.springeropen.com/articles/10.1007/s13244-017-0591-0

What to know about pelvic MRI for endometriosis. (2023). https://www.medicalnewstoday.com/articles/endometriosis-mri