The spectrum of imaging appearances of müllerian duct anomalies: focus on MR imaging

Abstract

Müllerian duct anomalies (MDAs) are the result of incomplete development, vertical or lateral fusion, or absorption of the müllerian ducts. The range of anomalies includes uterovaginal agenesis or hypoplasia, unicornuate uterus, uterus didelphys, bicornuate uterus, septate uterus, and arcuate uterus. Correct diagnosis and classification of these anomalies are essential because pregnancy outcomes and treatment options vary between the types of anomaly. Furthermore, early identification of MDAs helps to avoid prolonged symptomatic periods and the complications that may subsequently arise, such as infertility, endometriosis, and neoplasm. Although many of these abnormalities are initially diagnosed by ultrasound or hysterosalpingography, MR imaging is the most accurate noninvasive modality available for classification of the various anomalies because of its better anatomic assessment compared with other diagnostic modalities. Familiarity with the wide variety of MDA presentations can help in the planning of appropriate treatment.

Pregnancy and Childbirth in Uterus Didelphys: A Report of Three Cases

“…Although the initial diagnosis of uterus didelphys is made by ultrasound or hysterosalpingography, MRI offers the most accurate diagnosis. MRI is the best option for the classification of the various anomalies because of its better anatomic assessment compared with other diagnostic modalities [12]. Accurate diagnosis is essential to determine the most effective treatment during childbirth.…”

MRI of female genital tract congenital anomalies: European Society of Urogenital Radiology (ESUR) guidelines

“…Newer 3D T2W sequences seem to provide superior image quality and better 3D reconstructions compared with the classic 2D T2W sequences [20] with significant reduction in total scan time, compared with multiple 2D acquisitions [21]. The precise planning of the conventional scanning planes is not required [4] as images can be reformatted in any plane, including curved MPR [22] and double oblique through the uterus [18]. These 3D T2W sequences have different trade names: CUBE (GE), VISTA (Philips), SPACE (Siemens), among others [23].…”

“…Uterus, cervix and vagina MRI provides detailed information on the uterovaginal anatomy, particularly in the study of the external profile of the uterine fundus and the cavity shape, and it also allows tissue characterisation of the possible septa, thus providing a complete classification of the specific anomaly [22,25]. Currently, MRI presents the highest diagnostic accuracy in the characterisation of uterine anomalies (nearly 100%), owing to an excellent soft tissue resolution and multiplanar capability [26][27][28].…”

“…MRI is more accurate than US in the detection of rudimentary horns and can discriminate a non-functional rudimentary horn from a functional non-communicating rudimentary horn, thanks to its ability to evaluate the zonal anatomy and signal intensity involving the endometrial cavity and the possible presence of haematometra [22,29].…”

Differential diagnosis of the uterine septum: problems and solutions

“…3. Ультразвуковая 3D-реконструкция полости матки -двурогая матка: Ш -ширина полости матки; Г -глубина вдавления полости матки; угол В -угол вдавления полости возможности оценивать анатомические зо ны и интен сивность сигнала от эндометрия с помощью данного метода удается отличить нефункциональный рудиментарный рог от функционального несообщающегося рудиментарного рога [24,25]. В единичных работах описана роль динамической контраст-усиленной МРТ (ДКУ МРТ) в диагностике аномалий развития матки.…”