The Role of Radiological Examinations in The Diagnosis of Endometriosis (Literature Review)

Endometriosis is one of the most common chronic gynecological diseases affecting women of reproductive age and is characterized by the presence of endometrium-like tissue outside the uterine cavity. The disease is commonly associated with chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility, significantly impairing women’s quality of life and reproductive health. In addition, depending on the localization of endometriotic lesions, the disease may present with diverse clinical manifestations and symptoms. The variability of clinical signs and the asymptomatic course observed in some cases complicate early diagnosis of endometriosis. Timely detection and appropriate treatment of endometriosis require the use of radiological imaging methods, which represent a crucial diagnostic task. The application of these techniques contributes to improved patient quality of life and helps prevent disease-related complications. The main radiological methods used in the diagnosis of endometriosis include ultrasound examination (US), magnetic resonance imaging (MRI), and less frequently contrast-enhanced computed tomography (CT). Transvaginal ultrasound demonstrates high sensitivity in the detection of endometriomas (ovarian endometriotic cysts) and is widely used as a first-line diagnostic modality in clinical practice. MRI plays a particularly important role in cases of deep infiltrating endometriosis (DIE), where endometriotic lesions invade adjacent structures such as the intestines, urinary bladder, ureters, and surrounding tissues, allowing for accurate assessment of disease extent and spread. Radiological imaging is essential not only for the detection of endometriosis but also for evaluating the localization, size, complications of endometriotic lesions, adhesions, and associated anatomical changes. Furthermore, imaging techniques are of great importance in determining treatment strategy (medical or surgical), preoperative planning, and postoperative follow-up, making them indispensable tools in the clinical management of endometriosis.