Magnetic resonance imaging of endometriosis: a common but often hidden, missed, and misdiagnosed entity.

Abstract

Endometriosis is a common benign and chronic inflammatory gynaecological disease due to functional endometrial glands and stroma in an ectopic location outside the uterine cavity. It affects 5-10% of reproductive age group women in the peak age of 24-29 years. However, women with infertility and chronic pelvic pain have an even greater prevalence, accounting for 30-50% and 90% of cases, respectively. Although it is a common entity, patients often get a delayed diagnosis because it is often subtle (hidden), missed, or confused with mimics, leading to misdiagnosis, which significantly affects patients' quality of life because they live in constant pain from undiagnosed endometriosis. Laparoscopy followed by histopathological confirmation is the gold standard for diagnosis, but it is an invasive procedure. MRI is an excellent non-invasive modality that helps in non-invasive diagnosis, with excellent delineation of the disease extent, and thus provides a presurgical mapping of the disease, which is helpful for the operating surgeon. Radiologists should be aware of all possible spectrum and diagnose this early and provide a detailed structured report mapping the entire extent of the disease process, which helps in effective treatment planning and successful outcomes in improving patients' quality of life.