The use of imaging in endometriosis

Abstract

Endometriosis is a complex and often painful condition characterised by the presence of endometrial tissue outside the uterus. This may lead to inflammation, scarring and symptoms such as pelvic pain and infertility. It may manifest itself as superficial or deep disease as well as ovarian disease with the presence of endometriomas.

This study came to fruition in order to emphasise the importance of imaging with respect to the diagnosis of endometriosis. Whereas previously a surgical approach was the gold standard, imaging has now become the benchmark for diagnosis. The aim of this paper is to highlight the importance of imaging in endometriosis by reviewing literature on various databases such as PubMed and combining the most salient and relevant points. The goal is to underscore the previous points even further.

This literature review revealed that techniques such as ultrasound, magnetic resonance imaging (MRI) and computed tomography (CT) are utilised to visualise endometrial lesions, cysts and associated pelvic anatomy variations. Ultrasound, in particular transvaginal, is often the first-line imaging tool primarily because of its accessibility and non-invasiveness. MRI however is considered the gold standard for evaluating deep infiltrating endometriosis and is able to provide a detailed image of soft tissue structures. It is therefore the mainstay investigation prior to management planning and surgical intervention.

In conclusion, the use of imaging does not simply aid with management planning however, is able to assist in monitoring disease progression and response to treatment.