Magnetic Resonance Imaging for the Diagnosis of Female Genital Anomalies

Abstract

Aims: (1) to discuss the role of Magnetic Resonance Imaging (MRI) for the diagnosis of female genital anomalies, with emphasis on its ability to reliably demonstrate anatomy of female genital tract. (2) to describe the MR imaging technique and sequences for a comprehensive examination of the female pelvis in order to provide all the necessary information for the correct diagnosis and treatment planning of female genital anomalies. Brief description of the reviewed data: The MR imaging features of a wide range of female congenital anomalies are discussed, describing the key imaging findings important for the correct diagnosis, and associated uterine and adnexal pathology that may be encountered. The ESHRE-ESGE classification is used in all cases with cross-reference to the AFS classification nomenclature. The strengths of MRI, such as its ability to accurately demonstrate the outer fundal contour, the zonal anatomy of the uterus and cervix, thickness and composition of the uterine wall and septa, and capability to demonstrate associated pelvic pathology and renal congenital anomalies are discussed. Clinical implications: MRI is perfectly suited for the proper diagnosis of the different classes and sub-classes of female genital anomalies, providing high quality images of the female genital tract with fine anatomic detail, which is particularly useful for clinical management and surgical planning. It also detects concomitant uterine, adnexal and unsuspected abdominal pathology that can impact management and clinical decision-making. Open issues for further research: The role advanced MRI techniques in the fertility work-up of women with female genital anomalies seems to need further clarification.