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Abstract

MRI IN THE DIAGNOSIS OF CONGENITAL UTERINE MALFORMATIONS: A CASE REPORT AND LITERATURE REVIEW

Ahmed Rashid*, Nedham Aysha, Alfadhel Hani, Bunashi Mooza

ABSTRACT

Background: Congenital uterine abnormalities comprise a diverse and complex group of conditions which challenge the radiologist not only in obtaining optimal imaging but also in their interpretation. Uterine congenital anomalies are clinically relevant because these are associated with increased incidences of infertility and menstrual disorder. These are frequently not diagnosed at birth. These anomalies usually diagnosed at child®bearing age when reproductive malfunction arise. When normal mullerian duct development interrupted at any stage, it results in mullerian abnormality. It may present with infertility, spontaneous abortion, premature delivery, and fetal malposition. All that makes it very challenging to diagnose. Ultrasonography is the primary investigation; however, MRI is an excellent noninvasive investigation for accurate evaluation of uterine congenital anomalies. MRI is a very good modality to evaluate the vaginal malformation, which usually difficult to evaluate by ultrasound. It helps physicians and radiologists in the diagnosis of female genito-‐ urinary malformations, especially of complex cases, the embryology of the female genital tract, the basis for Müllerian development anomalies. Case: We report a case of an 18 years old single female lady who is known to have multiple congenital anomalies and underwent earlier an artificial vagina reconstruction in Jordan (made from bowel). She has a history of solitary pelvic kidney (congenital) multiple images done earlier for her including ultrasound, CT renal with and without contrast. Patient presented with a 3-‐ day history of severe abdomino-‐ pelvic pain, along with nausea and vomiting. MRI abdomen was done and revealed bicorneate uterine and blood collection in uterine cavity so underwent EUA and dilatation. Conclusion: MRI is an excellent noninvasive investigation to accurate estimation of morphology of uterus, cervix, and vagina in the congenital anomalies, which is very important in the treatment planning.

Keywords: Mullarian Duct Agenesis, Malformation.


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