Apports de l'imagerie dans le diagnostic de l'endométriose

Diagnosis of endometriosis is difficult because of the recurrence of the disease and delayed diagnosis. Recent advances in pelvic imaging allow earlier detection of endometriosis. Moreover, imaging may help in determination of therapeutic orientation. Ultrasonography is reliable to detect ovarian endometriomas with high sensitivity and specificity. Adenomyosis is seen as hypoechoic foci in the myometrium. Visualization is better with endovaginal probe. Conversely, deep lesions of endometriosis may be overlooked by sonography. MRI appears now as the essential examination for the diagnosis of endometriosis due to versatility of imaging planes, high spatial resolution and the capability to detect recent or old hemorrhagic lesions, which are quite usual in this disease. It is mandatory to perform MRI before any surgical planning. In selected cases, rectal endosonography can help if bowel endometriosis is suspected.