Purpose or Case Report: Three-dimensional (3D) imaging has emerged as a valuable tool in diagnosing pediatric Müllerian duct anomalies (MDAs), offering superior anatomical visualization and assessment compared to traditional imaging techniques with two-dimensional ultrasound. MDAs are frequently associated with other congenital anomalies of the cervix, vagina, or urinary tract, and are a common cause of infertility and pregnancy loss after adolescence.

In pediatric patients, MDAs are often discovered incidentally during imaging for other conditions. Magnetic resonance imaging (MRI) is the preferred modality for evaluating MDAs in children, providing multiplanar capabilities and detailed soft tissue characterization while avoiding ionizing radiation. MRI protocols for MDAs typically include T2-weighted sequences for visualizing uterine morphology and T1-weighted sequences to detect blood products in cases of associated endometriosis or hematometra .

The use of 3D MRI techniques allows for enhanced depiction of uterine and vaginal anatomy, and is particularly advantageous in differentiating complex anomalies such as septate and bicornuate uteri. Additionally, 3D reconstructions can provide a virtual hysterosalpingogram (MR-HSG), offering a comprehensive assessment of the reproductive tract without the need for invasive procedures. 3D imaging's accuracy extends to the detection of associated renal anomalies, given the concurrent development of the urinary and reproductive systems. Identifying these anomalies early is crucial for planning surgical interventions that may involve both gynecologic and urologic components .

Overall, 3D imaging significantly enhances the diagnostic accuracy and management of pediatric Müllerian duct anomalies. By providing detailed anatomical insights and allowing for non-invasive classification, it plays a critical role in guiding treatment strategies, reducing the need for repeat surgeries, and improving long-term reproductive outcomes for affected patients.

The purpose of this educational exhibit is to:
1. Review the embryology, classification, and imaging features of Müllerian duct anomalies using 3-dimensional imaging
2. Review the indications and techniques for surgical management of Müllerian duct anomalies in pediatric patients
3. Provide sample cases and clinical courses of patients with specific Müllerian duct anomalies with tips for implementation of 3-D imaging
4. Allow learners to test their knowledge with a quiz.
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