Learning objectives
To illustrate and recognize the fundamental characteristics of uterine congenital malformations using high-field MRI.
Our experience.
Background
Congenital malformations of the female genital tract have great clinical importance,
mainly in patients on reproductive age.
these results from anomalies in the formation,
fusion and ⁄or resorption of the septum of Müllerian ducts.
The American Fertility Society (AFS) clasification (Fig.
1):
I
Uterine agenesis or hypoplasia
II
Unicornuate uterus
III
Didelphys uterus
IV
Bicornuate uterus
V
Septate uterus (partial and complete)
VI
Arcuate uterus
VII
Drugrelated anomalies "DES"
The most common types areSeptate Uterus,
Bicornuate Uterus,
Arcuate Uterus,
Didelphys Uterus,
Unicornuate Uterus,
and Uterine...
Findings and procedure details
Procedure details:
A 1.5T and 3T MRI was used to perform the exams.
Protocol includedAxial T1 and T2 Spin Echo acquisitionimages of the pelvis,
and High- Resolution axial,
coronal,
and sagittal T2 images.
Images were obtained following the major and minor axes of the uterus.
In some cases it was necessary to apply endovaginal gel.
Imaging findings :
The distinctive characteristics of the cases evaluated in our institution from 05/2015 to 5/2016 are described and summarized in figures 2,
3 y 4.
Conclusion
MRIis an excellent noninvasive modality for evaluating the uterus.
It´s amethod of study with a sensitivity of up to 100%,
allowing a multiplanar evaluation and offering information of the inner and outer characteristics of the uterus.
The difficulty diagnosis of these congenital anomalies can be solved knowing their radiological distinctive characteristics.
Additionally,
it provides information on possibly associated congenital anomalies of the urogenital sinus,
providing a comprehensive assessment to plan further treatment.
Personal information
Ana Calderwood: Diagnostic Image Resident training program at Centro Medico Deragopyan,
C.A.B.A.,
Argentina.
References
1- Jáuregui Meléndrez Ra,
Alanís Fuentes J.
Estado Actual De La Clasificación,
Diagnóstico Y Tratamiento De Las Malformaciones Müllerianas.
Ginecol Obstet Mex 2013;81:34-46.
2- Junqueira Bl,
Allen Lm,
Spitzer Rf,
Lucco Kl,
Babyn Ps,
Doria As.
Müllerian Duct Anomalies And Mimics In Children And Adolescents: Correlative Intraoperative Assessment With Clinical Imaging.
Radiographics 2009;29:1085-103.
3- Saleem Sn.
Mr.Imaging Diagnosis Of Uterovaginal Anomalies: Current State Of The Art. Radiographics 2003;23:E13.
4- Cecilia Santos M.1,
Manuela Martín I.1,
Roberto Eduardo Correa S.
Servicio De Radiodiagnóstico.
Hospital Universitario De...