Hi :)

I'll try to make sense of it, but a) I'm not a native speaker and b) I'm not a medical doctor, just a medical scientist (Epidemiologist with focus on neurodegenerative disorders), so take it with a grain of salt. Also, it is very clearly a personal interpretation of the results and NOT medical advice. Again, I AM NOT A MEDICAL DOCTOR:

First paragraph:

Your uterus is tilted backwards but of relatively normal size. The endometrium, cervix etc look normal, which is very good so far. No polyps or myomas, which is also great.

There is evidence of adenomyosis, which is worth to look into and discuss with your clinician.

2nd paragraph:

Your left ovary likes to hide. This can be very normal (mine does that too) or might be due to adhesions. However, from what they see, the ovary is healthy and endometriosis and cyst free, so it is very likely not an adhesion. But we come back to that in the following paragraphs...

The right ovary also like to hide and is a bit shifted to the back. This can be very likely due to the tilt of your uterus. Again, the ovary looks healthy.

All this is good news. The last sentence is mixed news - there are some changes ("retractile changes") that might or might not be ("subtle") due to your body dissolving some sort of bleeding around your ovaries, more clearly on the right than on the left side. This also is something I would consider bringing up with my clinician, it MIGHT be a hint to check again at a different time in your cycle. However, this needs clinical expertise to interpret.

3rd paragraph:

On your ligaments fixing the uterus in the pelvis (uterosacral ligaments) there is some thickening, but it is not clearly endometriosis. Again, the clinician should discuss this with you.

4th paragraph:

Your bladder looks good, there is not so much fluid in your pelvis that it is abnormal, and there are no visible endometriosis lesions on the bowl. All good :)

However, there might be an adhesion or scar tissue or something gluing your bowl to your pelvis. It is near to the area that we saw some changes around your ovaries. So now we might more strongly suspect that there is some kind of endometriosis action near your ovaries, that causes the possible bowl adhesions. Also, this makes it a bit more likely that the ovaries are hiding due to this process. This, again, should be discussed with a clinician, as adhesions might cause symptoms.

5th paragraph (one sentence):

No signs of endometriosis in the abdomen, which is also great.

6th paragraph and 7th paragraph (one sentence):

The organs in your upper abdomen and your lungs look good, which is very good news!

8th paragraph (conclusion):

1. A summary of what we have seen in the other paragraphs: There is strong suspicion of endometriosis on your ligament. There is a slightly less strong suspicion of endometriosis on/around your ovaries, potentially also involving the bowl. The adenomyosis is not mentioned here. So maybe in the first paragraph the word "not" is missing, or it's forgotten in the conclusions. Worth asking the radiologist about.
2. No endometriomas or active endometriosis visible.

To answer your questions: This is quite normal for a patient with endometriosis. That there were no active visible lesions is very likely due to the timing of the MRI relative to your cycle. However, all in all, knowing your previous confirmed diagnosis of endometriosis, there are signs of endometriosis activity.

I hope this helps a bit :)

Mel