Magnetic Resonance Imaging in Evaluation of Endometriosis: Case-Based Pictorial Essay

We present a pictorial exhibit of endometriosis with a case-based overview of magnetic resonance imaging (MRI) findings in both pelvic and extra pelvic locations. All the cases with a clinical history of suspected endometriosis were reviewed retrospectively from the Picture Archiving and Communication System (PACS) database from 2020 to 2024. Cases with features of deep endometriotic implants, endometriomas, and surface endometriotic deposits were identified. Additionally, other spectrums of endometriosis, like adenomyosis, were also included. An MRI is the best imaging diagnostic tool for preoperative staging of endometriosis as it allows for performing a complete assessment of all the pelvic compartments and extrapelvic locations simultaneously. It helps to plan a multidisciplinary approach, which decreases the postoperative complication rates. It is helpful in followup cases after the surgical excision of deep endometriotic implants. Understanding the imaging findings and thorough knowledge about the pelvic anatomy increase the accuracy of endometriosis diagnosis.