Müllerian Duct Anomalies- Diagnostic Imaging in Pediatric and Adolescent Population

Abstract

Abstract Müllerian duct anomalies (MDAs) are congenital entities that result from the non-development, defective vertical or lateral fusion, or the resorption failure of the Müllerian (paramesonephric) ducts. MDAs represent a more frequent entity than previously believed. Few recent meta-analyses reported a prevalence of 5.5 - 6.7%. MDAs are commonly associated with other anomalies, specially kidneys, so identification of both kidneys is important. In pediatric and adolescent population MDAs are discovered incidentally at patients observed for some other reason or because of the primary amenorrhea and low abdominal pain related to hematometra (colpos). Imaging is essential for a diagnosis, management, and reproductive counseling in patients with MDA. Patients suspected of having the MDA are often initially referred to pelvic ultrasonography (US). Field-of-view restrictions with US, patient body habitus and artifact from bowel gas may result in a request for the further MagneticRresonance Iimaging (MRI). Also US cannot help identify the type of the MDA. MRI is the imaging standard of reference because it is non-invasive, does not involve ionizing radiation, has a multiplanar capability, allows an excellent soft-tissue characterization, detailed delineation of the uterovaginal anatomy and accurate classification of the type of anomaly. This is especially true for young female patients, in whom the use of vaginal US probes is avoided. Establishing an accurate diagnosis is essential for planning treatment and management strategies. The surgical management of MDAs is specific to the type of malformation and may vary in a specific group.