3 Mount Elizabeth #09-08 Mount Elizabeth Medical Centre Singapore 228510
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3 Mount Elizabeth #09-08 Mount Elizabeth Medical Centre Singapore 228510

Endometriosis Mapping Scan

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about Endometriosis Mapping Scan

Endometriosis Mapping Scan?

In patients with endometriosis, the condition often results in various degradation of the pelvic region. Common findings include chronic inflammation of the pelvis,  low muscle endurance accompanied by difficulty in relaxing pelvis muscles (persistent muscle contraction) nerve injuries and impaired motor functions. 

The pelvis is a complex basin-shaped organ that connects different organs, structures, muscles, ligaments, fascia, nerves, and blood vessels. Damage to one component can create a domino effect leading to the deterioration of other components in the pelvis. 

Due to the complexity of the condition, it is imperative to see a specialist to receive an accurate diagnosis and long-term management plan to comprehensively alleviate associated symptoms and mitigate the disease burden. The first step to treating endometriosis is to determine the progressiveness and severity of the condition. This will include a multi-step which entails:

  • A review of your medical history, as well as your family’s.
  • A review of your gynaecological history.
  • An assessment of your symptoms.
  • A physical examination.
  • A mapping scan of your pelvic region (the most crucial element of the assessment).
The pelvic is a complex organ that connects multiple organs, and houses the uterus.

What is an endometriosis mapping scan?

An endometriosis mapping scan is a diagnostic imaging procedure performed via transvaginal ultrasonography. This scan fundamentally enables your healthcare provider to have a better visualisation of your pelvic region; 

The ENZIAN classification accurately describes the location and size of deep infiltrating endometriosis. Depending on the specific location of deep infiltrating endometriosis, a letter combination is assigned in the ENZIAN classifications. For letters A to C there is an additional number describing the size.

How does endometriosis mapping scan help with management of endometriosis?

Below are the key findings an endometriosis scan provides; 

  1. Identifies the organs, and structures that are affected by endometriosis.
  2. Determines the extent of the damage caused by endometriosis.
  3. Detects deep infiltrating endometriosis.
  4. Determines the size of deep endometriosis nodules within the pelvis.
  5. Projecting the severity of the condition to formulate preventative strategies. 

Essentially, an endometriosis mapping scan draws out the pelvis to mark and reveal the location, size, and depth of the endometriosis. The importance of these key details cannot be overstated. Endometriosis patients face continued degradation in their quality of life due to the failure to capture the unique deterioration of their bodies induced by the condition. An endometriosis mapping scan thus empowers patients by providing extensive and exhaustive analysis to create a bespoke and personalised treatment plan.

Ultrasound vs. MRI vs. CT: Pros & cons, and limitations in diagnosing endometriosis

As endometriosis is a difficult condition to diagnose, it is important to receive a proper diagnosis that is accompanied by a thorough imaging test. Below is a breakdown of the advantages, and disadvantages of different imaging tests, and how they impact the outcome of diagnosing endometriosis: 

Imaging Tests

Ultrasound

MRI

CT Scan

Advantages

  • Non-invasive 
  • Does not require any specialised equipment, or radiation.
  • Provides real-time imaging.
  • Effective at identifying ovarian endometriomas.
  • Enables doctors to test the mobility and relationship of different organs.
  • Enables the doctor to assess the pain level and elasticity of pelvic tissue.
  • Non-invasive procedure.
  • Produces a high-resolution image that shows the pelvic anatomy in detail, which helps in identifying deep infiltrating endometriosis, and the depth, and extent of endometriosis lesions.
  • It enables doctors to assess the surrounding organs, such as the bowel, bladder, and ureters, to determine the complexity, or severity of the condition.
  • It does not expose patients to any radiation.
  • Non-invasive, and quick procedure.
  • Produces detailed cross-sectional images which helps in determining endometriosis spread.
  • Widely available in different healthcare settings. 

Limitations 

  • Challenges in detecting small, or superficial lesions as well as adhesions.
  • highly operator dependent. 
  • Need to be done by a trained endometriosis specialist. 
  • Limited view field makes it difficult to assess upper abdominal conditions. 
  • Challenges in detecting small, or superficial endometriosis lesions.
  • The machine is not widely, and readily available in all healthcare settings
  • It tends to be more expensive than other imaging tests. 
  • Patients with metallic foreign bodies, like a pacemaker, are not advised to undergo an MRI.
  • It is unable to test the mobility of the organs.
  • It is less effective at differentiating between soft tissues, thereby making it difficult to distinguish endometriosis lesions, from other soft tissues
  • Due to its poor image quality, it is easier to mistake the abnormality for other possible conditions.
  • It exposes patients to radiation, which is unideal for patients who may require multiple scans.



In the assessment of endometriosis, it is crucial to select a healthcare provider who is experienced with the condition to thoroughly review test findings. An endometriosis mapping that utilizes transvaginal ultrasonography provides a more comprehensive evaluation and accurate diagnosis, leading to more effective treatment planning and management strategies.

 

A transvaginal ultrasound offers a comprehensive, and detailed imaging of the condition of the uterus.
FAQs

Frequently asked questions

No, an endometriosis mapping scan is not painful. However, it can cause some slight discomfort as the doctor manoeuvres the probe to capture images of your uterus, and its nearby organs.
The procedure normally takes between 10 to 20 minutes.
Yes, it is suitable for all women with endometriosis of all ages.
The frequency of an endometriosis mapping scan is determined on a case-by-case basis. While some patients may require 2 sessions (pre-, and post-treatment), others may require more frequent mapping to monitor, and observe if the endometriosis recurs.
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