Endometriosis Mapping: Why an Accurate Diagnosis Matters?

This is going to be a very concise, precise, and short guide. My goal is to help you understand the value of a well-done endometriosis mapping.

As a gynecologist who has been diagnosing and treating this condition for years, I want to make sure you see why expert-led imaging can completely change the way we diagnose and treat endometriosis.

There are officially two techniques for radiological diagnosis of endometriosis:

• Ultrasound (USG)
• Magnetic Resonance Imaging (MRI)

Both can help in diagnosis, but the accuracy depends not only on the technology but more importantly on the expertise of the operator who performs the scan.

Ultrasound-based endometriosis mapping is an excellent diagnostic tool because it allows for a dynamic assessment of the pelvis. This is possible only with ultrasound, because we can use the probe to gently press on the organs and study their mobility with each other, which is also called the sliding sign.

This dynamic assessment is so crucial because it’s not possible, even with a gel contrast MRI. An MRI is a completely static test, capturing a single snapshot. Endometriosis, however, can tether and bind organs together, and we need to see how they move—or don’t move—to truly understand the extent of the disease.

As practicing surgeons, we are highly trained in understanding the disease. Because of this, we often take a step forward into the diagnostic side as well. With years of experience seeing endometriosis daily, we develop accuracy in diagnosing the disease on imaging, not just in surgery.

Ultrasound mapping is an excellent diagnostic tool because it allows for something MRI cannot: dynamic assessment of the pelvis.

With ultrasound, we can use the probe to press over organs and assess their mobility with each other. This is called the sliding sign.

Even with gel contrast, an MRI remains a static test—it cannot provide this dynamic evaluation. This dynamic element is critical in diagnosing the extent of endometriosis.

To diagnose endometriosis correctly, expertise and protocol matter more than just the machine.

I want to be very honest here—when I started back in 2015, I missed many cases of endometriosis. The reason was not a lack of intent, but because the protocol I used was not optimal.

With years of practice, refinement, and learning, I now identify 90–95% of lesions accurately. This allows me to give patients the correct information and plan treatment more effectively.

A proper reporting protocol is essential. Here’s how we systematically assess endometriosis:

• Pelvis first—primary mapping starts here.
• Bladder involvement—checked thoroughly.
• Sigmoid colon and rectum—evaluated carefully.
• Ureters and parametrium—studied for disease spread.
• Renal fossa – assessed if needed.
• Endometrium (with 3D plane, rarely)—in rare cases, we use 3D ultrasound to assess further.

Thanks to ultrasound, we can categorically understand the depth and extent of invasion. This helps us make better surgical decisions for our patients.

Endometriosis mapping, when done by an expert sonologist or surgeon, is one of the most reliable and accurate ways to plan treatment. It’s not just about detecting the disease—it’s about understanding its depth, spread, and effect on surrounding organs so that surgery and treatment can be planned with precision.

If you’re struggling with endometriosis symptoms or planning surgery, getting an accurate endometriosis mapping by an expert can make all the difference.

Dr. Jay Mehta performs detailed ultrasound-based endometriosis mapping in Mumbai, India, using internationally accepted protocols and years of surgical experience to ensure nothing is missed.

You don’t need to keep guessing about your condition.

👉 Schedule a consultation today at  1800-268-4000 and get a clear diagnosis with a personalized treatment plan.