Case 13
History:
22 year old female with history of dysmenorrhea
Findings:
Coronal MRI images of the pelvis showing 2 uterine cavities, large and distended on the right side and a smaller one on the left.
Diagnosis:
Discussion:
Didelphic uterus results from complete nonfusion of both müllerian ducts. Two separate uterine bodies with two cervices are present. A longitudinal or transverse vaginal septum may also be encountered. Associated renal anomalies which typically are ipsilateral can be associated and include renal agenesis, ectopic kidney, cystic dysplasia, and duplicated collecting system. The likelihood of having a successful pregnancy with a uterus didelphys is approximately 60 percent. Surgical correction of a uterus didelphys is rarely indicated, but pregnant women should be closely monitored for proper cervical function.
MRI is the most sensitive imaging modality for these congenital anomalies – particularly in cases of non-communicating horn which will not be depicted by conventional hysterosalpingogram.
References:
- Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH. Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiology 1992; 183:795-800
- Shokry MA, Saleem SN. Magnetic resonance imaging in the management of congenital anomalies of female reproductive system. Middle East Fertil Soc J 2001; 6:123-133.
- Minto CL, Hollings N, Hall-Craggs M, Creighton S. Magnetic resonance imaging in the assessment of complex müllerian anomalies. BJOG 2001; 108:791-797
