MRI

The MRI examination in endometriosis is dedicated mainly to the preoperative evaluation of deep endometriosis and complements the clinical and ultrasound examinations. A qualitative examination should provide the surgeon with a more detailed map of the lesions, and begins with a good communication between the gynecologist and the imaging doctor and continues with a more detailed discussion between the imaging doctor and the patient.

Knowing the patient’s symptoms is of real use in guiding the examination protocol so a medical history will be asked before the test. Gel instillation is used intravaginally and intrarectal. The water-based gel relaxes the cavities, thus leading to better visualization of the walls and possible endometriosis nodules, with the possibility of evaluating the depth of the infiltration zone. By contrast, offered by the gel, a better delineation of the peritoneal recesses (recto-vaginal and bladder-vaginal recession) is obtained. Also, the presence of gel reduces peristaltic artefacts.

For intestinal endometriosis, the role of the MRI exam is to preoperatively evaluate the depth of endometriotic infiltration, nodules that affect the muscularis propria and have an indication for resection.