Why ultrasound isn’t good at detecting endometriosis

An ultrasound doesn’t provide all the information needed to diagnose endometriosis. But it can offer clues that your provider can use to decide next steps when it comes to making a diagnosis. An ultrasound can provide information that your provider uses to suggest treatments, too.

Ultrasounds can show large clumps of tissue that are likely signs of endometriosis. Ultrasounds are also very good at identifying endometriosis of the ovaries. But ultrasounds can’t show tiny pieces of tissue that may also be signs of endometriosis. Not all tissue is the same with endometriosis. Ultrasounds can show some, but not all, types of tissue.

An ultrasound can show:

Endometrial tissue that’s turned into cysts (endometriomas).
Endometrial tissue that’s embedded deeply in an organ (Deeply infiltrating endometriosis, or DIE).

An ultrasound can’t show:

Endometrial tissue that’s tiny and on the surface of an organ.

The tricky part is that even if the ultrasound shows tissue that doesn’t belong, there’s no way to be 100% sure it’s endometrial tissue. The only way to know for sure is to remove the tissue and test it. This requires surgery, a procedure called a laparoscopy. But an ultrasound can let your provider know that you likely have endometriosis, without surgery, and allows them to plan your surgery more effectively.

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