Frank Matt,  List Jeb,  Harris Katherine

Final Pr. ID: Poster #: CR-07 (R)

12 year old female presented with history of ureteral re-implantation and severe pelvic pain for a month. Pelvic ultrasound showed a bi-lobed hypoechoic mass in the pelvis markedly distended with internal intermediate and low level echoes and septations suggestive of hematometrocolpos thought to be secondary to imperforate hymen. Subsequent MRI evaluation of the pelvis demonstrated a complete septate uterus with longitudinal vaginal septum, atresia of the lower 1/3 of the vagina, and hematocolpos. The patient was placed on Lupron and referred for reconstructive surgery. Read More

Authors:  Frank Matt , List Jeb , Harris Katherine

Keywords:  Septate uterus, longitudinal vaginal septum, Mullerian duct anomaly, Septate uterus MRI, longitudinal vaginal septum MRI

Myers Ross,  Li Tianyang,  Wu Jennifer,  Sadowsky David,  Paul Mary,  Gerard Perry,  Brudnicki Adele,  Lecompte Lesli

Final Pr. ID: Poster #: EDU-034

Müllerian Duct Anomalies (MDA) are a broad category of congenital deformities of the urogenital structures due to abnormal development, fusion, or resorption of the fetal Müllerian Ducts. By definition, the Müllerian Ducts are the paired fetal structures that are located medially to the Wolffian Ducts and develop into the Fallopian Tubes, uterus, cervix, and upper two-thirds of the vagina. The multitude of symptoms associated with MDAs vary broadly in severity, ranging from patients with no symptoms and incidentally discovered MDAs to patients with primary infertility, recurrent pregnancy loss and other reproductive problems.

There are well documented associations of MDAs with other genitourinary malformations. The most commonly reported is renal agenesis, which accounts for up to 30% of all associated renal anomalies in the setting of MDA, however abnormalities including ureteral remnants with ectopic insertion or collecting system duplication have been reported as well. The overall incidence of MDAs varies, but have been estimated to be approximately 1-5% within the general population and up to 13-25% in patients with recurrent pregnancy loss.

The most commonly accepted system of classification of the various types of MDAs is that of the American Fertility Society, which divides MDAs into seven categories. However, there is often confusion as to how to categorize MDAs demonstrating characteristics of more than one class. Medical imaging is of essential importance for both this reason and for appropriate planning of therapy. The imaging of suspected MDAs involves the implementation of a combination of 3D Ultrasound, Magnetic Resonance Imaging, Sonohysterography, Hysterosalpingraphy and/or laparoscopy. Sonography and MRI have the benefits of being the least invasive methods of diagnosis.

The goal of our educational exhibit will provide an overview of the embryology and pathophysiology related to a broad variety Müllerian Duct Anomalies. We will discuss the common imaging techniques employed in the workup of patients with Müllerian Anomalies. In addition, we provide a plethora of interesting cases from our home institution including a case of Mayer-Rokitansky-Küster-Hauser Syndrome, Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA), cloacal abnormality, bicornuate uterus and other complex cases utilizing a variety of imaging modalities. Read More

Authors:  Myers Ross , Li Tianyang , Wu Jennifer , Sadowsky David , Paul Mary , Gerard Perry , Brudnicki Adele , Lecompte Lesli

Keywords:  Mullerian Duct Anomalies, OHVIRA