OP24.08: Magnetic resonance imaging of complications due to uterine anomalies

Abnormalities of Müllerian ductal development represent an extensive spectrum of malformations. Abnormalities may occur during any phase of development, including formation of the paired Müllerian ducts, fusion of the paired ducts, and septal absorption. Complications may occur due to these malformations. It is imperative for the radiologist to accurately and definitively diagnose these complex malformations which will impact management and have prognostic significance. We reviewed our database for patients presenting with symptoms of pelvic pain, abnormal vaginal bleeding, amenorrhea, hematometros, hematocolpos, endometriosis, ectopic pregnancy, and recurrent pregnancy loss and the imaging findings were consistent with a uterine anomaly. Imaging findings were reviewed, and cases were categorised according to a modified classification system used by the American Fertility Society. Uterine anomalies were identified, accurately described, and classified according to disorders of organogenesis, vertical fusion, lateral fusion, or complex and difficult to classify. The spectrum of cases included uterine hypoplasia, septate uterus, bicorporeal uterus, unicornuate uterus with and without rudimentary horn, and uterine aplasia/agenesis. Management decisions and appropriate treatment were implemented according to type of malformation. Magnetic resonance imaging is considered the gold standard for the diagnosis of uterine anomalies. MR does not involved ionising radiation, has multiplanar capability, and offers excellent soft tissue contrast. MR imaging allows the radiologist to provide exquisite analysis of uterovaginal anatomy, thereby guiding appropriate management and intervention for straightforward and complex uterine anomalies.