Imaging Characteristics of Müllerian Duct Anomalies and Effects on Outcomes

Abstract

Category: Genitourinary Radiology Modality: MRI, Ultrasound uterine contour. Magnetic resonance imaging (MRI) is the imaging gold standard for the characterization of MDAs because of its multiplanar imaging capabilities, and superior soft tissue resolution. MRI has the ability to correctly classify an MDA and guide management. MDAs arise when failure occurs in the development of the uterus, cervix, and upper vagina from the Müllerian ducts during female embryogenesis. MDAs represent a spectrum of abnormalities with variations; however, key components may be identified on imaging to classify anomalies into subtypes, with implications for women’s reproductive outcomes. In patients undergoing workup for infertility, the prevalence has been reported to be as high as 25%.1,2 Correctly identifying the subtype of MDA is essential for optimizing medical and surgical management. MRI and US play a critical role in diagnosis and characterization of MDAs. Computed tomography (CT) is not often used in the workup of MDAs due to its use of ionizing radiation and poor soft tissue characterization when compared with MRI. In this review, we describe the embryology, epidemiology, and classification of MDAs. We discuss distinctive imaging features of each subtype of MDA for classification, and highlight the complications and management of each.