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Müllerian Duct Anomalies: Imaging and Clinical Issues¹

¹ From the Departments of Radiology and Obstetrics and Gynecology, Weill Medical College of Cornell University, 1300 York Ave, New York, NY 10021 (R.M.T.), and Department of Radiology, Yale University School of Medicine, New Haven, Conn (S.M.M.). Received June 25, 2002; revision requested August 22; final revision received August 25, 2003; accepted September 29. Address correspondence to R.N.T. (e-mail: rnt2001@med.cornell.edu).

While estimates of the frequency of müllerian duct anomalies vary widely owing to different patient populations, nonstandardized classification systems, and differences in diagnostic data acquisition, these anomalies are clinically important, particularly in women who present with infertility. An understanding of the differences between these uterovaginal anomalies, as outlined in the most widely accepted classification system—that published by the American Fertility Society (AFS) in 1988—is imperative given the respective clinical manifestations, different treatment regimens, and prognosis for fetal salvage. Although the AFS classification system serves as a framework for description of anomalies, communication among physicians, and comparison of therapeutic modalities, there often is confusion about appropriate reporting of certain anomalies, particularly those with features of more than one class. Many of the anomalies are initially diagnosed at hysterosalpingography and ultrasonography; however, further imaging is often required for definitive diagnosis and elaboration of secondary findings. At this time, magnetic resonance imaging is the study of choice because of its high accuracy and detailed elaboration of uterovaginal anatomy. Laparoscopy and hysteroscopy are reserved for women in whom interventional therapy is likely to be undertaken.

© RSNA, 2004

Index terms: Genitourinary system, abnormalities • Genitourinary system, MR, 85.121411 • Genitourinary system, radiography, 85.1282 • Genitourinary system, US, 85.12981, 85.12983 • State of the Art • Uterus, abnormalities, 854.1411, 854.1413, 854.14783, 854.14784

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