Endometriosis is a disease that affects the pelvic region, uterus and ovaries, and it occurs when the uterine lining grows outside of the uterus. The tissue can grow within the ovaries, fallopian tubes, ligaments, and other areas within your abdomen, and it can cause a number of painful symptoms that can be difficult to manage.
Unfortunately, endometriosis is difficult to diagnose because the symptoms can vary dramatically, and many other conditions might cause the same effects. Despite this, it’s estimated that around 190 million women and girls are affected by endometriosis globally.
This is why detection is so important to help people affected manage their symptoms and get the help they need. Surgery is the only surefire way to diagnose endometriosis, but MRI scans have also shown promising results in helping to detect and confirm symptoms of endometriosis.
How Do Endometriosis MRI Scans Work?
An MRI is a non-invasive medical imaging procedure that creates high-quality images of the pelvis and its surrounding areas. It uses a powerful magnetic field and radio waves to create detailed pictures of the pelvis, offering highly accurate results for finding ovarian endometrioma and deep infiltrating endometriosis. If a positive marker is found on the MRI, it’s 80% likely that endometriosis is present. However, even if the scan shows no positive markers for the condition, 30% of patients are still found with endometriosis present.
MRI scans are more expensive than transvaginal ultrasounds but they’re often necessary for certain groups of people. The scan looks for several endometriosis markers, including:
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Endometrioma
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Upper rectal distortion
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Fixed uterine anteversion and/ or retroflexion
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Thickened uterosacral ligaments
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Haematosalpinx
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Posterior cul-de-sac obliteration
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Uterine serosal plaques
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Elevated vaginal fornices
Why Might You Need an Endometriosis MRI?
Many people with endometriosis find it difficult to tolerate pelvic scans as the pressure on the area can exacerbate their pain, making them unwilling or nervous to have the procedure done. Most doctors will offer a transvaginal ultrasound to look for endometrial tissue, but this isn’t always a good option for people with severe pelvic pain, transgender men, or teenagers. In these cases, your doctor might refer you to get a pelvic MRI.
How To Prepare for Your Endometriosis MRI?
When your doctor recommends an endometriosis MRI, make sure you tell them if you have any of the following:
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A pacemaker or artificial heart valve
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Ear implants
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Metal plates or pins
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Electrical devices, such as baclofen pumps or vagal nerve stimulators
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Dental spacers or retainers
They should ask about these things beforehand, but it’s still worth mentioning them to your doctor so they have all the information. You should also bring all the information about any medically implanted device you have to your appointment.
The MRI machine features a large magnet that will draw metals to it, so it’s important that all jewellery, keys, cards, and electronics are taken off your person before entering the MRI room. Certain medical devices and even eyeliners can include metals, so these should be avoided or disclosed to your doctor, too.
There are no restrictions on drinking, but it’s often asked that you don’t eat for one hour before your appointment. You may also be asked to take a pregnancy test before the MRI, so make sure you have a partially full bladder upon arrival.
What To Expect From an MRI Scan of Your Pelvis
During the Scan
Once you’ve been seen by your doctor and assessed before your scan, you’ll be taken down to the procedure room by a technologist and asked to change into a gown and remove all your belongings. You’ll be asked some questions about your medical history before they start an IV for your MRI contrast injection, although this won’t be administered until nearer the end of your scan.
The MRI will last for around 45 minutes. The technologist will give you two syringes filled with ultrasound gel and tell you how to administer them before stepping out for privacy reasons. These should be dispensed to help expand your vaginal canal and rectum, which can help the MRI machine pick up on better imaging of these areas.
After you’re done placing the gel, the technologist will come back, position you in the scanner and give you headphones to help calm you during the scan. The machine makes a loud thumping machine while taking pictures, so the headphones can be helpful in drowning this out.
An MRI coil is placed on your stomach, which feels like a heavy blanket and is used to transmit information to the imaging computer to create your pictures.
The first 30 minutes of your scan will consist of you lying still, while the last bit will have you holding your breath for short periods of time. Your technician will walk you through the instructions and keep you informed of what’s happening throughout the entire time you’re being scanned.
After the Scan
Once the scan is finished, you’ll be taken to the bathroom to clean up. You’ll often be given a pad to wear to protect your clothing from any residual ultrasound gel, and you’ll be advised to drink more fluids for the next 48 hours. This helps the kidneys flush out the MRI contrast quickly. Some patients are given a sedative before their scan, and if this is the case for you, you’ll be advised to have someone else drive you home. However, if you haven’t had a sedative, you should be able to leave straight away and go about your day like normal.
What Are the Benefits of an MRI Scan of the Pelvis?
There are several benefits of an endometriosis MRI, including:
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It can help with surgery planning: If your doctor recommends surgery to remove endometrial tissue, MRI images can help plan where they need to focus on during your laparoscopy
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MRIs produce clear images without ionising radiation: Unlike other imaging tests, MRI machines don’t use ionising radiation while still producing clear images to help your doctor reach an accurate diagnosis
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They’re non-invasive: MRI scans are non-invasive, unlike transvaginal ultrasounds, making them better suited to a wider range of people suffering from endometriosis symptoms
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MRI scans can detect deep endometriosis: These scans can create images of more than just your uterus, so it’s more likely to find deep endometriosis in unusual locations, such as around the bladder or bowel, which might otherwise go undetected
What Are the Risks of an MRI Scan of the Pelvis?
There aren’t many risks associated with MRI scanning of the pelvis because the machine doesn’t use radiation. However, it’s important to remember that MRI machines are magnetic, and therefore, you need to remove everything with metal on your person before going into the scanning room. Your technician should remind you of this before taking you in to make sure you aren’t put in any danger.
In rare cases, some patients have had an allergic reaction to the contrast material used in an MRI. This can lead to hives and difficulty breathing, so it’s important to tell your doctor if you have a history of allergic reactions.
Other Common MRI Scans
As well as endometriosis MRI scans, several other types of MRI scans are used to assess different parts of the body. These include:
These scans use the same basic method as an endometriosis MRI scan but with the technician focusing on different areas of the body. The same principles apply, although it’s unlikely you’ll need to use ultrasound gel in other MRI scans.
Your doctor will be able to refer you to the best kind of MRI scan for the ailments you’re facing.
FAQs
How Long Does an Endometriosis MRI Take?
Most endometriosis MRI scans take around 45 to 60 minutes to complete, although this depends on your technician and whether the scanner can pick up clear images quickly or not. Most scans don’t take longer than 60 minutes, and this includes positioning you in the scanner and getting you ready.
What Does an Endometriosis MRI Show?
An endometriosis MRI lets your doctor find any sites of deep endometriosis, which may have attached themselves to the uterus, ovaries, bladder, bowel, and surrounding space in the pelvis. This will give them a better idea of where to plan your surgery to remove as much tissue as possible, hopefully reducing your symptoms as much as possible.
Is an Endometriosis MRI Uncomfortable?
Endometriosis MRI scans are generally not painful or uncomfortable, and they can be more comfortable than the alternative (a transvaginal ultrasound). However, you might find the loud noise of the machine and the confined space within the scanner to be a little unnerving. You should be provided headphones to help with the notice, and if you’re really struggling with the thought of having the scan, some doctors may offer a sedative to relax you.
How Much Does an Endometriosis MRI Cost?
The average cost of an endometriosis MRI in Australia is between $300 and $500. Some insurance plans should cover the cost of your MRI scan, but others might require you to pay a portion of the overall cost. You’ll need to check with your insurance provider to get an accurate indication of how much you’ll need to pay before your scan.
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