MRI in the evaluation of müllerian duct anomalies

Objective: Müllerian duct anomalies (MDAs) result from nondevelopment or nonfusion of the müllerian ducts and occur in 1–5% of women. Accurate diagnosis of the various subtypes is of great importance as MDAs are frequently associated with a broad variety of clinical symptoms. Recently, evidence arose that MRI might play a major role in diagnosis of MDAs. We present four cases of diverse subtypes of MDAs and the corresponding MRI findings. Materials and methods: Patients (n=4) with clinical suspicion of MDAs were examined with MRI. Coronal and transaxial T1- and T2-weighted images were acquired. Diagnosis was made and patients were grouped according to the American Fertility Societyʹs classification. Patients underwent laparoscopy or laparotomy in order to confirm the diagnosis. Results: MRI revealed MDAs in all patients. In detail, one patient was diagnosed with hypoplastic uterus, one with unicornuate uterus with a noncommunicating rudimentary horn, one with bicornuate uterus bicollis with a double vagina and one with septate uterus. MRI diagnosis was correct in all cases, as confirmed by subsequent surgical intervention. Conclusion: MRI is a valuable tool in diagnosis of MDA subtypes. Its use will help to spare patients mutilating surgery and to prevent pregnancy-associated complications.