While laparoscopy is the gold standard for diagnosing endometriosis, doctors can use pelvic magnetic resonance imaging (MRI) as a less invasive option. MRI is effective at identifying endometriosis.

However, endometriosis may not always be visible on an MRI scan. If this is the case, doctors may not find definitive proof of endometriosis until a laparoscopy, a surgical procedure that uses small incisions to examine the organs in the abdomen and pelvis.

A pelvic MRI is an imaging test that produces detailed images of the structures inside the body, including:

  • organs
  • bones
  • muscles
  • blood vessels

An MRI may show the fibrosis and adhesions, or bands of scar tissue, characteristic of endometriosis, which are often found on the ovaries and other pelvic organs.

In a 2024 study involving 40 females with a suspicion of endometriosis, MRI helped correctly identify endometriosis in about 90% of participants who later received a definitive diagnosis through a diagnostic laparoscopy.

However, only about 33% of the participants that doctors identified as not having endometriosis through the MRI did not receive a positive endometriosis diagnosis during the laparoscopy. That means that about 67% of participants who received a negative diagnosis from the MRI received a positive diagnosis from the laparoscopy.

Doctors may not find definitive evidence of endometriosis on an MRI, but a person may still have endometriosis. A follow-up laparoscopy may be important if your MRI results do not explain your symptoms.

An MRI requires no special preparation, but you may have to change your clothes. A technician will either administer a contrast agent through an IV or have you take it orally.

Be sure to inform the technicians if you:

  • could possibly be pregnant
  • are breastfeeding
  • have ever had an allergic reaction to a contrast agent
  • have kidney problems
  • have metal in your body or any kind of implant

MRI machines use strong magnets, and having certain types of metals or implants in your body can cause serious harm.

Something metal in your body may not mean you can’t have an MRI scan, as it depends on the specific material.

How long does a pelvic MRI for endometriosis take?

A pelvic MRI usually takes between 30 and 90 minutes, but if you need a contrast dye, you may also have to wait after taking the dye before the scan.

Because MRI technology involves taking images, like pictures, of your internal organs, moving may cause the images to blur. If the technician has to redo some of the pictures, it can take longer.

Some technicians may tell you when they are going to begin taking the images, so you can prepare to keep your body still. They can give you a break if you need one.

They may also play music during the scan. Having something to focus on may help you stay still.