High prevalence of endometriosis in women with chronic pelvic pain and confirmed pelvic varicosities: a multiparametric MRI study

• Endometriosis was found in 61.5 % of women with chronic pelvic pain and confirmed pelvic varicosities. • Multiparametric MRI allows non-invasive, simultaneous detection of vascular and gynecological abnormalities. • Integrated imaging may improve diagnostic workup in women with chronic pelvic pain. Chronic Pelvic Pain (CPP) presents significant diagnostic challenges, often involving multiple pathologies, including endometriosis and pelvic venous disorders. This study examined the prevalence of endometriosis among women with confirmed pelvic varicosities. The authors performed a retrospective analysis of 52 women with CPP and pelvic varicosities who underwent multiparametric magnetic resonance venography between January 2019 and December 2023. All images were reviewed by a single experienced radiologist, blinded to clinical data and vascular findings, to identify radiological signs of endometriosis. Among the 52 women, 32 exhibited radiological findings consistent with endometriosis, corresponding to a prevalence of 61.5% (95% CI: 47.0%–74.5%). This study demonstrates a high prevalence of endometriosis among women with pelvic varicosities. Multiparametric MRI proved effective as a non-invasive diagnostic modality capable of identifying both vascular and gynecologic abnormalities in a single session, supporting integrated assessment approaches for women with CPP. Limitations include the retrospective design and the lack of histological confirmation of endometriosis.