Endometriosis is a common gynecological problem, affecting approximately 5% of women.
The disease has different manifestation and could
present as an ovarian cysts (endometrioma), superficial endometriosis, and deep infiltrative endometriosis (DIE).
The non-endometrioma type of the disease could be found in different site of the pelvic including the col- de-sac, the uterosacral ligaments, the uterovesical region, and the rectovaginal septum.
The degree of pelvic adhesions and the patient’s symptoms differ between these different features. Considering the difference in the symptoms and treatments, correct site-specific mapping of the pelvic involvement is of great importance.
The firs line non-invasive method for endomeriosis mapping is trans-vaginal ultrasound (TVS).
The recent consensus statement, suggests a standard TVS approach to all patients suspected for the pelvic endometriosis. This approach is formed of four basic steps, which evaluate the uterine, and ovaries, presence of any pelvic adhesion, presence of DIE in the anterior or posterior compartments.
MRI is a second step imaging modality, and could be suggested in any case with non specific ultrasound findings, in patients suspected for malignancy, or to determine the extent of the disease in the regions non accessible by ultrasound.