Ultrasonographic Imaging Features of Accessory Cavitated Uterine Malformations and Application to Diagnosis

Ruijie Sun, Liu X, Xinting Liu, Wei N, Niya Wei, Xiaokun Li, Li X, Ying Zou, Zou Y, Wang Y, Yue Wang
Journal of clinical ultrasound : JCU · 2025 · vol. 53(8) , pp. 1707–1712 · doi:10.1002/jcu.24043 · PMID:40346936
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⚙ AI-generated summary by claude@2026-07, 2026-07-16 ⓘ

This study analyzed ultrasonographic features in nine ACUM cases, finding distinct cystic structures and vascularity, confirming ultrasound's 100% diagnostic accuracy for this rare malformation.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This retrospective study analyzed ultrasonographic imaging features in nine patients with accessory cavitated uterine malformations (ACUM), with diagnoses made by ultrasound and confirmed by surgery and pathology at a single hospital between 2020 and 2024. Most patients had severe and progressive dysmenorrhea, and preoperative ultrasonography matched surgical findings with a 100% diagnostic coincidence rate. Ultrasound characteristics included solitary round or oval thick-walled cystic lesions (88.9% solitary) on the anterior lateral uterine wall below the uterine horn, not connected to the uterine cavity, with internal ground-glass-like or hyperechoic appearance and circular or semicircular vascularity; the authors also reported no adenomyosis or other uterine lesions. The paper is centrally about endometriosis or adenomyosis-related imaging? Relevance to endometriosis: it explicitly states that no adenomyosis was found on examination, though the study’s main focus is diagnosis of accessory cavitated uterine malformations using ultrasound.

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Abstract

OBJECTIVE: To analyze the ultrasonographic imaging features of accessory cavitated uterine malformations (ACUM) and discuss the practical value of ultrasonography in diagnosing this disease. METHODS: A retrospective analysis was conducted on nine cases of ACUM diagnosed by ultrasound and confirmed by surgery and pathology at Peking University Shenzhen Hospital from October 2020 to August 2024. The ultrasonic imaging features of ACUM were summarized. RESULTS: The average age of the nine patients with ACUM was 28.3 years (range: 18-39 years). Only one patient exhibited mild dysmenorrhea, while the remaining eight patients experienced severe and progressive dysmenorrhea. Among those with severe dysmenorrhea, the average age was 19.9 years (range: 13-38 years), and the mean time of onset after menarche was 6.5 years (range: 0-25 years). The results of preoperative ultrasonography were consistent with the surgical results, and the diagnostic coincidence rate was 100%. Preoperative ultrasound showed eight cases (88.9%) appeared as solitary lesions, and one case (11.1%) exhibited two cystic cavities on the same side of the uterus. Lesions were located on the anterior lateral wall of the uterus, below the uterine horn, with a median maximum diameter of (24.4 ± 3.6) mm. Lesions were round or oval and not connected to the uterine cavity, with clear boundaries, presenting as regular thick-walled cystic structures. Cystic areas were observed within the mass with a ground-glass-like appearance (88.9%) or hyperechoic (11.1%). The surrounding area of the mass showed resemblance to the muscular layer, and circular or semicircular vascularity was detected around the mass. No adenomyosis or other uterine lesions were found. CONCLUSIONS: ACUM is a rare obstructive reproductive tract malformation that affects young women. Progressive aggravation of dysmenorrhea serves as its main clinical manifestation. ACUM exhibits distinct ultrasound characteristics; preoperative ultrasonography can be used to accurately diagnose ACUM through identification of typical manifestations, providing a reliable imaging basis for diagnosis and treatment management.
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Abstract

Objective To analyze the ultrasonographic imaging features of accessory cavitated uterine malformations (ACUM) and discuss the practical value of ultrasonography in diagnosing this disease.

Methods

A retrospective analysis was conducted on nine cases of ACUM diagnosed by ultrasound and confirmed by surgery and pathology at Peking University Shenzhen Hospital from October 2020 to August 2024. The ultrasonic imaging features of ACUM were summarized.

Results

The average age of the nine patients with ACUM was 28.3 years (range: 18–39 years). Only one patient exhibited mild dysmenorrhea, while the remaining eight patients experienced severe and progressive dysmenorrhea. Among those with severe dysmenorrhea, the average age was 19.9 years (range: 13–38 years), and the mean time of onset after menarche was 6.5 years (range: 0–25 years). The results of preoperative ultrasonography were consistent with the surgical results, and the diagnostic coincidence rate was 100%. Preoperative ultrasound showed eight cases (88.9%) appeared as solitary lesions, and one case (11.1%) exhibited two cystic cavities on the same side of the uterus. Lesions were located on the anterior lateral wall of the uterus, below the uterine horn, with a median maximum diameter of (24.4 ± 3.6) mm. Lesions were round or oval and not connected to the uterine cavity, with clear boundaries, presenting as regular thick-walled cystic structures. Cystic areas were observed within the mass with a ground-glass-like appearance (88.9%) or hyperechoic (11.1%). The surrounding area of the mass showed resemblance to the muscular layer, and circular or semicircular vascularity was detected around the mass. No adenomyosis or other uterine lesions were found.

Conclusions

ACUM is a rare obstructive reproductive tract malformation that affects young women. Progressive aggravation of dysmenorrhea serves as its main clinical manifestation. ACUM exhibits distinct ultrasound characteristics; preoperative ultrasonography can be used to accurately diagnose ACUM through identification of typical manifestations, providing a reliable imaging basis for diagnosis and treatment management. Conflicts of Interest The authors declare no conflicts of interest. Data Availability Statement The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Condition tags

dysmenorrheaadenomyosis

MeSH descriptors

Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities Urogenital Abnormalities

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