Pelvic protocol for endometriosis (MRI)

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Pelvic protocol for endometriosis (MRI)

Evaluation of known endometriosis with MRI requires a slightly different protocol to a routine pelvic MRI (see Pelvic MRI protocol: routine), and should probably be reserved for known cases of endometriosis rather than for the assessment of pelvic pain.

IV (or IM) Buscopan is administered to reduce bowel peristalsis and hence improve image quality.

A good protocol involves:

  • body coil
  • T1W and T2W axial
  • T1W fat-suppressed sequences : axial, sagittal and coronal

Gadolinium is not particularly useful in the evaluation of endometriomas  and does not improve detection of very small implants as small vessels enhance and may be misinterpreted as a small endometriotic deposit . Additionally, enhancement of endometrial deposits is variable post contrast and does not differentiate from other benign or malignant processes.

See also