Pelvic protocol for endometriosis (MRI)

Last revised by Andrew Murphy on 19 Sep 2021

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 1: axial, sagittal and coronal

Gadolinium is not particularly useful in the evaluation of endometriomas 2 and does not improve detection of very small implants as small vessels enhance and may be misinterpreted as a small endometriotic deposit 1. Additionally, enhancement of endometrial deposits is variable post contrast and does not differentiate from other benign or malignant processes.

See also

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