Ultrasound and MRI for Adolescent Endometriosis: Consistent Detection of Ovarian Endometrioma and Deep Disease, but Superficial Disease Often Missed

In a scoping review of imaging for adolescent endometriosis, ovarian endometrioma and posterior deep endometriosis were most consistently detected. Superficial disease was poorly captured, and normal imaging was common in symptomatic patients. Most primary studies used ultrasoun…

• Ultrasound was the sole or initial modality in eight of nine primary studies; MRI was used in four.
• Normal imaging should never be interpreted as excluding endometriosis, particularly superficial disease, when symptoms persist.
• The primary evidence base was limited, heterogeneous, mostly adult-derived, and lacked adolescent-specific studies on AI-assisted imaging.

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