Although it’s not the most definitive test for endometriosis, MRI scans are a useful tool in your doctor’s diagnostic tool belt. MRI images of your pelvic area show your internal organs and tissues, like your ovaries, fallopian tubes, and bladder.

Your doctor may order a pelvic MRI to look for evidence of endometriosis, like endometrial lesions and scar tissue, or to learn more about the location and size of endometrial growths.

To diagnose and treat endometriosis, doctors use a combination of tactics. The gold standard diagnostic test for endometriosis is a minimally invasive surgical procedure called laparoscopy. But the first steps in your diagnosis journey will probably be a pelvic exam and an ultrasound.

Keep reading to learn more about where MRIs fit into the diagnosis process, what you can expect from the procedure, and how much they typically cost.

An MRI is a type of imaging test that creates detailed pictures of internal structures within your body. When you go inside an MRI machine, the scanner uses a large magnet and radio waves to capture detailed pictures of your organs, bones, muscles, and other tissues.

A pelvic MRI can capture images of endometrial growths that lie within the pelvic cavity. An MRI can see deeper into the body than an ultrasound. This means it can help your doctor identify deeply infiltrating endometriosis.

Endometriosis happens when endometrial-like tissue, which is only supposed to grow inside the uterus, starts growing on nearby structures like the ovaries and fallopian tubes. In rare cases, it can also develop in other areas of the body.

Things your doctor may be able to see in an endometriosis MRI include:

  • Peritoneal implants: small growths on the surface of your pelvic organs or the tissue lining your abdominal cavity
  • Adhesions: bands of dense, fibrous tissue that can alter the position of pelvic organs or cause them to stick together
  • Endometriomas: small blood-filled cysts that form on the surface of the ovaries
  • Deep infiltrating endometriosis: growths that extend beyond the peritoneum into deeper layers of tissue or muscle
  • Bladder endometriosis: growths that affect the bladder, ureter, kidney, or urethra

An MRI is not typically the first choice imaging test. Before moving on to an MRI, doctors typically perform an ultrasound.

Ultrasound is an imaging technique that uses sound waves to create pictures of your internal organs. It may be done with a wand placed on the abdomen or inserted into the vagina.

Your doctor may order an MRI for endometriosis when they need to gather more information about your condition. Your doctor may suggest an MRI to:

  • help them reach a diagnosis
  • identify the size, depth, and location of endometrial growths and adhesions
  • find out whether endometriosis is affecting organs, like the bladder or bowels
  • help them create a “map” of lesions to remove during surgery

An MRI exam cannot confirm a diagnosis of endometriosis. The only way an endometriosis diagnosis can be officially confirmed is if a doctor sees it during laparoscopy.

A laparoscopy is a minimally invasive surgical procedure that allows doctors to see inside the abdominal cavity. They make a small incision in your belly and insert a long, thin tube with a light and a camera attached.

During a laparoscopy, doctors can treat endometriosis by removing or destroying endometrial growths, scar tissue, and adhesions.

While no special preparation is necessary for most MRIs, your doctor may suggest that you fast for 3 to 6 hours before a pelvic MRI. They may also ask you to empty your bladder before the exam. Menstruation will not interfere with the procedure.

Before you enter the exam room, you will be asked to remove anything metallic you might be wearing. This includes items such as jewelry, watches, zippers, certain makeup, and anything else that could contain metal.

Depending on your doctor’s orders, the MRI technician may give you an IV containing contrast dye. This helps make it easier for them to identify certain structures in the images. The technician may also place small devices around your hip area that send and receive radio signals.

If you often experience claustrophobia or feel uncomfortable in confined spaces, it’s important to let your doctor know. They may be able to make accommodations.

While the exact time frame varies, a typical MRI procedure takes between 20 and 90 minutes.

During your MRI, you will lie on a table inside a giant machine. Because image quality is affected by movement, it’s important to be very still.

When the machine starts, the specialized scanner rotates around your body to capture images from all the necessary angles.

It can be very loud inside the machine, so your technician will give you ear plugs or headphones to help reduce discomfort. You’ll also have an emergency call button to hold in your hand in case you need to get out.

The national average for an MRI is estimated to cost $1,408. Your exact cost will depend on a variety of factors. These include your healthcare professional, where you live, and your insurance.

Before undergoing a pelvic MRI, contact your insurance company to see how much of the procedure they will cover. If costs are a concern, discuss this with your doctor.

If you don’t currently have insurance, ask about possibly getting this procedure at a reduced cost. Many MRI providers offer discounts and payment plans.

If you’ve received a diagnosis of endometriosis, it’s important to know that several treatment options may help you manage your symptoms.

Talk with a doctor about the following options:

Hormonal birth control

Often considered a first-line treatment, birth control pills and shots, as well as intrauterine devices (IUDs), may help reduce pain and heavy bleeding.

Hormonal birth control may be a good option if your symptoms are mild to moderate.

Gonadotropin-releasing hormone (GnRH) agonists

This type of medication may be a better option if you’re planning on getting pregnant soon.

GnRH agonists work by reducing the production of hormones responsible for ovulation and menstruation, which can help stop endometrial tissue growth.

GnRH agonists are taken temporarily. Once you stop taking them, you may find it easier to get pregnant.

Surgery

For severe endometriosis, your doctor may recommend laparoscopic surgery to remove endometrial growths and adhesions.

Surgery may also be an option if you’re having difficulties getting pregnant due to endometriosis.

Other diagnostic tools used to evaluate and treat endometriosis include:

  • Ultrasound imaging. During this test, a doctor may use a scanner outside your abdomen or a wand that’s inserted in the vaginal wall.
  • Medications. Your doctor may prescribe certain medications, like GnRH agonists, to see whether they help. If your symptoms improve, this could indicate endometriosis.
  • Laparoscopic surgery. With the help of a small camera at the end of a long flexible tube, a doctor will be able to identify (and treat) endometrial growths and pelvic adhesions.
  • Laparotomy. This is a more invasive type of surgery. It involves a larger incision in the abdomen through which a doctor can identify endometriosis.
  • Biopsy. In the case of laparoscopy or laparotomy, your doctor may send samples of tissue to a laboratory to be examined under a microscope.

An MRI is a way for doctors to see what’s going on deep inside the body. MRI images can show endometrial growths on the pelvic organs.

MRIs may be particularly useful for people with suspected deep infiltrating endometriosis. They are also used to help doctors identify the size and location of endometrial lesions so they can make a surgical plan.