MRI of Pregnancy-Related Issues: Mullerian Duct Anomalies

Department of Radiology, University of Wisconsin School of Medicine and Public Health, Clinical Science Center, MC 3252, 600 Highland Ave, Madison, WI 53792, USA.
American Journal of Roentgenology (Impact Factor: 2.73). 02/2012; 198(2):302-10. DOI: 10.2214/AJR.11.7789
Source: PubMed


OBJECTIVE: Müllerian duct anomalies can adversely affect pregnancy outcomes and can result in clinical symptoms. This article will review the appropriate management of patients with müllerian duct abnormalities. CONCLUSION: Whereas uterine and vaginal septa, vaginal agenesis, and unicornuate uterus can be managed surgically, other uterine anomalies tend to be managed clinically. Hence, appropriate management depends on a reliable assessment of pelvic anatomy. MRI can accurately display female pelvic anatomy and is, therefore, useful in guiding therapy.

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    ABSTRACT: The müllerian ducts are paired embryologic structures that undergo fusion and resorption in utero to give rise to the uterus, fallopian tubes, cervix, and upper two-thirds of the vagina. Interruption of normal development of the müllerian ducts can result in formation of müllerian duct anomalies (MDAs). MDAs are a broad and complex spectrum of abnormalities that are often associated with primary amenorrhea, infertility, obstetric complications, and endometriosis. MDAs are commonly associated with renal and other anomalies; thus, identification of both kidneys is important. However, MDAs are not associated with ovarian anomalies. Hysterosalpingography (HSG) is routinely used in evaluation of infertility. Because a key component of MDA characterization is the external uterine fundal contour, HSG is limited for this purpose. Patients suspected of having an MDA are often initially referred for pelvic ultrasonography (US). Magnetic resonance (MR) imaging is typically reserved for complex or indeterminate cases. MR imaging is the imaging standard of reference because it is noninvasive, does not involve ionizing radiation, has multiplanar capability, allows excellent soft-tissue characterization, and permits a greater field of interrogation than does US. Use of MR imaging for evaluation of MDAs reduces the number of invasive procedures and related costs by guiding management decisions. © RSNA, 2012.
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    ABSTRACT: To report a case of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA syn-drome) with uterus didelphys that has been diagnosed successfully with ultrasound and managed with a single stage vaginoplasty.
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