Role of Imaging in Rare Obstructive Reproductive Tract Anomalies: an Enigma—a Case Report

Abstract

Mullerian duct anomalies (MDAs) result from abnormalities occurring during the embryologic development of mullerian ducts. Among the various mullerian abnormalities, obstructive reproductive tract anomalies (ORTA) form an interesting and difficult group to diagnose. This case series emphasize the role of imaging, specifically magnetic resonance imaging (MRI) in evaluating such cases before surgery. The clinical presentation of ORTA is in two ways, either with primary amenorrhea and pain or with menstrual periods and progressive dysmenorrhea. In ORTA, it is important to identify the site of obstruction, as surgical management depends upon the site of obstruction. Hence, the role of imaging is important in such cases. When suspecting MDAs especially ORTA, an initial screening ultrasound should be followed by MRI because of its multiplanar capability, excellent soft tissue characterization, and absence of ionizing radiation. All MRI examinations in our study were performed using 3 T MRI system using a phased array body coil. Here we are reporting three rare cases of ORTA presented to our institute where MRI identified the exact site of obstruction before surgery, leading to better preoperative planning. Hence MRI should be mandatory part of workup of this group of patients.