Best Practices: Ultrasound Versus MRI in the Assessment of Pelvic Endometriosis
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⤵ 11 in-corpus citations
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This review found that dedicated ultrasound and MRI showed similar diagnostic accuracy for pelvic endometriosis, with modality choice depending on regional expertise, though ultrasound better assessed bowel-wall invasion and MRI pelvic-wall disease.
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Abstract
Endometriosis is a common yet morbid disease. Imaging plays an important role in diagnosis and treatment planning. Both ultrasound (US) and MRI are used to detect disease. We performed a literature review to assess whether one is superior. A total of 33 studies from the 4482 identified in the initial search were found to assess the efficacy of US and/or MRI in detecting pelvic endometriosis. Most studies were performed at centers with extensive experience with endometriosis, using dedicated US and MRI protocols. A wide range of sensitivities and specificities were reported, but overall weighted means of diagnostic statistics for US and MRI were similar. The choice of dedicated US versus dedicated MRI in the evaluation of endometriosis should therefore be based on the expertise in the region. The data also showed US had better accuracy than MRI for identifying the depth of wall invasion in bowel-wall disease, whereas MRI better depicted pelvic-wall and extraperitoneal disease than US. Routine US and MRI protocols performed worse than dedicated US and MRI protocols, which may account for delays in diagnoses. Clinical and research efforts directed at improving the sensitivity of routine imaging for diagnosing deep endometriosis could improve patient access to appropriate care.
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Cited by (11)
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- Chronic Pelvic Pain: A Trauma-Informed Approach to Diagnosis and Treatment 2026
- Proposed new MRI scoring system of rectosigmoid endometriosis to guide operative planning 2025
- Endometriomas on routine pelvic ultrasound (US) as an indication for MRI for deep endometriosis (DE) 2025
- Optimizing endometriosis detection: a review of technical approaches and interpretative pitfalls 2025
- Comprehensive Review of Endometriosis Care 2025
- The Role of MRI in Diagnosis and Pre-Surgical Mapping of Endometriosis 2025
- Advancing endometriosis detection in daily practice: a deep learning-enhanced multi-sequence MRI analytical model 2025
- Sonographische Endometriosediagnostik 2025
- Deep endometriosis demystified: Natural progression, hormonal treatment, and malignant transformation 2025
- MRI directed US for rectosigmoid endometriosis provides added value for preoperative planning 2025
Source provenance
- europepmc
- last seen: 2026-06-18T06:15:08.409253+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-06-18T06:12:46.966435+00:00
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