Advertisement

Female Genital Anomalies and Important Ovarian Conditions

  • Gisela Schweigmann
  • Theresa E. Geley
  • Ingmar Gassner
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Congenital anomalies of the female genital tract result from Müllerian duct anomalies and/or abnormalities of the urogenital sinus or cloaca. Understanding the development of the urogenital system is necessary to comprehend the full spectrum of these anomalies.

In this chapter we explain the embryology of the female genitalia and describe Müllerian duct anomalies, female hypospadias, and urogenital sinus in disorders of sex development (DSD) and cloacal malformations.

Ovarian cysts are frequently seen on ultrasound, and ovarian torsion is an important differential diagnosis in lower abdominal pain or ovarian mass and has therefore been included in this chapter, although they are not closely related etiologically to the abovementioned malformations and organ systems.

Ultrasound is the primary imaging modality for the evaluation of the female genital tract. Complementary fluoroscopic examinations and in some cases abdominal radiographs provide additional information. In selected cases and prior to surgery, magnetic resonance imaging is used in this field.

Keywords

Female genital anomalies Müllerian duct anomalies Urogenital sinus anomalies Cloacal malformations Disorders of sex development Female hypospadias Ovarian cysts Ovarian torsion Ultrasound Fluoroscopy Magnetic resonance imaging 

References

  1. Acién P, Acién MI (2011) The history of female genital tract malformation classifications and proposal of an updated system. Hum Reprod Update 17(5):693–705PubMedCrossRefGoogle Scholar
  2. Adams ME, Hiorns MP, Wilcox DT (2006) Combining MDCT, micturating cystography, and excretory urography for 3D imaging of cloacal malformation. AJR Am J Roentgenol 187:1034–1035PubMedCrossRefGoogle Scholar
  3. American Fertility Society (1988) The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil Steril 49:944–955CrossRefGoogle Scholar
  4. Balk SJ, Dreyfus NG, Harris P (1982) Examination of genitalia in children: the remaining taboo. Pediatrics 70:751–753PubMedGoogle Scholar
  5. Barbaro M, Wedell A, Nordenström A (2011) Disorders of sex development. Semin Fetal Neonatal Med 16(2):119–127PubMedCrossRefGoogle Scholar
  6. Barkovich AJ (2012) Pediatric neuroimaging, vol 862, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, pp 887–888Google Scholar
  7. Barwick TD, Malhotra A, Webb JA, Savage MO, Reznek RH (2005) Embryology of the adrenal glands and its relevance to diagnostic imaging. Clin Radiol 60:953–959PubMedCrossRefGoogle Scholar
  8. Bazi T, Berjawi G, Seoud M (2006) Inguinal ovaries associated with Mullerian agenesis: case report and review. Fertil Steril 85:1510–1518PubMedGoogle Scholar
  9. Behr SC, Courtier JL, Qayyum A (2012) Imaging of Müllerian duct anomalies. Radiographics 32:E233–E250PubMedCrossRefGoogle Scholar
  10. Blask AR, Sanders RC, Gearhart JP (1991a) Obstructed uterovaginal anomalies: demonstration with sonography. I. Neonates and infants. Radiology 179:79–83PubMedCrossRefGoogle Scholar
  11. Blask AR, Sanders RC, Rock JA (1991b) Obstructed uterovaginal anomalies: demonstration with sonography. II. Teenagers. Radiology 179:84–88PubMedCrossRefGoogle Scholar
  12. Bok G, Drews U (1983) The role of the Wolffian ducts in the formation of the sinus vagina: an organ culture study. J Embryol Exp Morphol 73:275–295PubMedGoogle Scholar
  13. Brandt ML, Helmrath MA (2005) Ovarian cysts in infants and children. Semin Pediatr Surg 14:78–85PubMedCrossRefGoogle Scholar
  14. Brandt ML, Luks FI, Filiatrault D et al (1991) Surgical indications in antenatally diagnosed ovarian cysts. J Pediatr Surg 26:276–282PubMedCrossRefGoogle Scholar
  15. Buttram VC, Gibbons WE (1979) Müllerian anomalies: a proposed classification (an analysis of 144 cases). Fertil Steril 32:40–46PubMedCrossRefGoogle Scholar
  16. Ceballos R, Hicks GM (1979) Plastic peritonitis due to neonatal hydrometrocolpos: radiologic and pathologic observations. J Pediatr Surg 5:63–70CrossRefGoogle Scholar
  17. Chan-Cua S, Freidenberg G, Jones KL (1989) Occurrence of male phenotype in genotypic females with congenital virilizing adrenal hyperplasia. Am J Med Genet 34:406–410PubMedCrossRefGoogle Scholar
  18. Chang HC, Bhatt S, Dogra VS (2008) Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics 28:1355–1368PubMedCrossRefGoogle Scholar
  19. Chavhan GB, Parra DA, Oudjhane K, Miller SF, Babyn PS, Pippi Salle JL (2008) Imaging of ambiguous genitalia: classification and diagnostic approach. Radiographics 28:1891–1904PubMedCrossRefGoogle Scholar
  20. Chertin B, Hadas-Halpern I, Fridmans A, Kniznik M, Abu-Arafeh W, Zilberman M, Farkas A (2000) Transabdominal pelvic sonography in the preoperative evaluation of patients with congenital adrenal hyperplasia. J Clin Ultrasound 28:122–124PubMedCrossRefGoogle Scholar
  21. Chiou SY, Lev Toaff AS, Masuda E et al (2007) Adnexal torsion new clinical and imaging observations by sonography, computed tomography, and magnetic resonance imaging. J Ultrasound Med 26:1289–1301PubMedCrossRefGoogle Scholar
  22. Cohen HL, Shapiro MA, Mandel FS et al (1993) Normal ovaries in neonates and infants: a sonographic study of 77 patients 1 day to 24 months old. AJR Am J Roentgenol 160:583–586PubMedCrossRefGoogle Scholar
  23. Collins GM, Kim DU, Logrono R, Rickert RR, Zablow A, Breen JL (1993) Pure seminoma arising in androgen insensitivity syndrome (testicular feminization syndrome): a case report and review of the literature. Mod Pathol 6:89–93PubMedGoogle Scholar
  24. Currarino G (1982) Single vaginal ectopic ureter and Gartner’s duct cyst with ipsilateral renal hypoplasia and dysplasia (or agenesis). J Urol 128:988–993PubMedCrossRefGoogle Scholar
  25. Currarino G (1986) Large prostatic utricles and related structures, urogenital sinus and other forms of urethrovaginal confluence. J Urol 136:1270–1279PubMedCrossRefGoogle Scholar
  26. Donahoe PK, Crawford JD, Hendren WH (1979) Mixed gonadal dysgenesis, pathogenesis, and management. J Pediatr Surg 14:287–300PubMedCrossRefGoogle Scholar
  27. Drews U (2007) Helper function of the Wolffian ducts and role of androgens in the development of the vagina. Sex Dev 1:100–110PubMedCrossRefGoogle Scholar
  28. Duncan PA, Shapiro LR, Stangel JJ, Klein RM, Addonizio JC (1979) The MURCS association: Müllerian duct aplasia, renal aplasia, and cervicothoracic somite dysplasia. J Pediatr 95(3):399–402PubMedCrossRefGoogle Scholar
  29. Ehammer T, Riccabona M, Maier E (2011) High resolution MR for evaluation of lower urogenital tract malformations in infants and children: feasibility and preliminary experiences. Eur Radiol 78:388–393CrossRefGoogle Scholar
  30. Fielding JR (1996) MR imaging of Müllerian anomalies: impact on therapy. AJR Am J Roentgenol 167:1491–1495PubMedCrossRefGoogle Scholar
  31. Fedele L, Ferrazzi E, Dorta M, Vercellini P, Candiani GB (1988) Ultrasonography in the differential diagnosis of “double” uteri. Fertil Steril 50(2):361–364PubMedCrossRefGoogle Scholar
  32. Gambino J, Caldwell B, Dietrich R, Walot I, Kangarloo H (1992) Congenital disorders of sexual differentiation: MR findings. AJR Am J Roentgenol 158:363–367PubMedCrossRefGoogle Scholar
  33. Gassner I, Geley TE (2004) Ultrasound of female genital anomalies. Eur Radiol 14(Suppl 4):L107–L122PubMedCrossRefGoogle Scholar
  34. Gharagozloo AM, Lebowitz RL (1994) Detection of poorly functioning malpositioned kidney with single ectopic ureter in girls with urinary dribbling. AJR Am J Roentgenol 164:957–961CrossRefGoogle Scholar
  35. Ghossain MA, Hachem K, Buy JN, Hourany-Rizk RG, Aoun NJ, Haddad-Zebouni S, Mansour F, Attieh E, Abboud J (2004) Adnexal torsion: magnetic resonance findings in the viable adnexa with emphasis on stromal ovarian appearance. J Magn Reson Imaging 20:451–462PubMedCrossRefGoogle Scholar
  36. Gilsanz V, Cleveland RH (1982) Duplication of the Müllerian ducts and genitourinary malformations. Part I: the value of excretory urography. Radiology 144:793–796PubMedCrossRefGoogle Scholar
  37. Gilsanz V, Cleveland RH, Reid BS (1982) Duplication of the Müllerian ducts and genitourinary malformations. Part II: analysis of malformations. Radiology 144:797–801PubMedCrossRefGoogle Scholar
  38. Goske MJ, Emmens RW, Rabinowitz R (1984) Inguinal ovaries in children demonstrated by high resolution real-time ultrasound. Radiology 151:635–636PubMedCrossRefGoogle Scholar
  39. Graif M, Itzchak Y (1988) Sonographic evaluation of ovarian torsion in childhood and adolescence. AJR Am J Roentgenol 150:647–649PubMedCrossRefGoogle Scholar
  40. Graif M, Shalev J, Strauss S et al (1984) Torsion of the ovary: sonographic features. AJR Am J Roentgenol 143:1331–1334PubMedCrossRefGoogle Scholar
  41. Gruenwald P (1941) The relation of the growing Müllerian ducts to the Wolffian duct and its importance for the genesis of malformations. Anat Rec 81:1–19CrossRefGoogle Scholar
  42. Hartwig NG (1992) Pathoembryology: developmental processes and congenital malformations. Thesis, State University Leiden, LeidenGoogle Scholar
  43. Haque TL, Togashi K, Kobayashi H, Fujii S, Konishi J (2000) Adnexal torsion: MR imaging findings of viable ovary. Eur Radiol 10:1954–1957PubMedCrossRefGoogle Scholar
  44. Hassink EAM, Rieu PNMA, Hamel BCJ, Severijnen RSVM, vd Staak FHJ, Festen C (1996) Additional congenital defects in anorectal malformations. Eur J Pediatr 155:477–482PubMedCrossRefGoogle Scholar
  45. Hendren H (1998) Cloaca, the most severe degree of imperforate anus. Ann Surg 228:331–346PubMedPubMedCentralCrossRefGoogle Scholar
  46. Hernanz-Schulman M, Brock JW III, Russell W (2002) Sonographic findings in infants with congenital adrenal hyperplasia. Pediatr Radiol 32:130–137PubMedCrossRefGoogle Scholar
  47. Hersmus R, Kalfa N, de Leeuw B, Stoop H, Oosterhuis JW, de Krijger R, Wolffenbuttel KP, Drop SL, Veitia RA, Fellous M, Jaubert F, Looijenga LH (2008) FOXL2 and SOX9 as parameters of female and male gonadal differentiation in patients with various forms of disorders of sex development (DSD). J Pathol 215(1):31–38PubMedCrossRefGoogle Scholar
  48. Holterhus PM, Werner R, Hoppe U, Bassler J, Korsch E, Ranke MB, Dorr HG, Hiort O (2005) Molecular features and clinical phenotypes in androgen insensitivity syndrome in the absence and presence of androgen receptor gene mutations. J Mol Med 83:1005–1013PubMedCrossRefGoogle Scholar
  49. Homer HA, Li TC, Cooke ID (2000) The septate uterus: a review of management and reproductive outcome. Fertil Steril 73(1):1–14PubMedCrossRefGoogle Scholar
  50. Hughes IA, Houk C, Ahmed SF, Lee PA, LWPES/ESPE Consensus Group (2006) Consensus statement on management of intersex disorders. Arch Dis Child 91:554–563PubMedPubMedCentralCrossRefGoogle Scholar
  51. Hurh PJ, Meyer JS, Shaaban A (2002) Ultrasound of a torsed ovary: characteristic gray-scale appearance despite normal arterial and venous flow on Doppler. Pediatr Radiol 32:586–588PubMedCrossRefGoogle Scholar
  52. Imperato-McGinley J, Zhu YS (2002) Androgens and male physiology: the syndrome of 5alpha-reductase-2 deficiency. Mol Cell Endocrinol 198:51–59PubMedCrossRefGoogle Scholar
  53. Jaramillo D, Lebowitz RL, Hendren WH (1990) The cloacal malformation: radiologic findings and imaging recommendation. Radiology 177:441–448PubMedCrossRefGoogle Scholar
  54. Jarcho J (1946) Malformation of the uterus: review of the subject, including embryology, comparative anatomy, diagnosis and report of cases. Am J Surg 71:106–166PubMedCrossRefGoogle Scholar
  55. Jedrzejewski G, Stankiewicz A, Wieczorek AP (2008) Uterus and ovary hernia of the canal of Nuck. Pediatr Radiol 38:1257–1258PubMedCrossRefGoogle Scholar
  56. Karrer FM, Flannery AM, Nelson MD, McLone DG, Raffensperger JG (1988) Anorectal malformations: evaluation of associated spinal dysraphic syndromes. J Pediatr Surg 3:45–48CrossRefGoogle Scholar
  57. Kato H, Kanematsu M, Uchiyama M, Yano R, Furui T, Morishige K (2014) Diffusion-weighted imaging of ovarian torsion: usefulness of Apparent Diffusion Coefficient (ADC) values for the detection of hemorrhagic infarction. Magn Reson Med Sci 13:39–44PubMedCrossRefGoogle Scholar
  58. Kiechl-Kohlendorfer U, Geley TE, Unsinn KM, Gassner I (2001) Diagnosing neonatal female genital anomalies using saline-enhanced sonography. AJR Am J Roentgenol 177:1041–1044PubMedCrossRefGoogle Scholar
  59. Kiechl-Kohlendorfer U, Maurer K, Unsinn KM, Gassner I (2006) Fluid debris level in follicular cysts: a pathognomonic sign of ovarian torsion. Pediatr Radiol 36:421–425PubMedCrossRefGoogle Scholar
  60. Kiechl-Kohlendorfer U, Geley T, Maurer K, Gassner I (2011) Uterus didelphys with unilateral vaginal atresia: multicystic dysplastic kidney is the precursor of “renal agenesis” and the key to early diagnosis of this genital anomaly. Pediatr Radiol 41:1112–1116PubMedCrossRefGoogle Scholar
  61. Kluth D, Hillen M, Lambrecht W (1995) The principles of normal and abnormal hindgut development. J Pediatr Surg 30:1143–1147PubMedCrossRefGoogle Scholar
  62. Knight HML, Phillips NJ, Mouriquand PDE (1995) Female hypospadias: a case report. J Pediatr Surg 30:1738–1740PubMedCrossRefGoogle Scholar
  63. Koopman P (1995) The molecular biology of SRY and its role in sex determination in mammals. Reprod Fertil Dev 7:713–722PubMedCrossRefGoogle Scholar
  64. Lang IM, Babyn P, Oliver GD (1999) MR imaging of paediatric uterovaginal anomalies. Pediatr Radiol 29:163–170PubMedCrossRefGoogle Scholar
  65. Lee EJ, Kwon HC, Joo HJ, Suh JH, Fleischer AC (1998) Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J Ultrasound Med 17(2):83–89PubMedCrossRefGoogle Scholar
  66. Lee HJ, Woo SK, Kim JS, Suh SJ (2000) “Daughter Cyst” sign: a sonographic finding of ovarian cyst in neonates, infants and young children. AJR Am J Roentgenol 174:1013–1015PubMedCrossRefGoogle Scholar
  67. Levitt MA, Peña A (2010) Cloacal malformations: lessons learned from 490 cases. Semin Pediatr Surg 19:128–138PubMedCrossRefGoogle Scholar
  68. Lindsay AN, Voorhess ML, MacGillivary MH (1983) Multicystic ovaries in primary hypothyroidism. Obstet Gynecol 61:433–437PubMedGoogle Scholar
  69. Lobo L (2015) Recommendation for an imaging algorithm in neonatal and childhood ano-rectal/cloacal malformation. Pediatr Radiol 45(S2):S310Google Scholar
  70. Ludwig KS (1998) The Mayer-Rokitansky-Küster syndrome. An analysis of its morphology and embryology. Part I: morphology. Part II: embryology. Arch Gynecol Obstet 262:1–42PubMedCrossRefGoogle Scholar
  71. MacGillivary MH, Morishimo A, Conte F, Grumbach M, Smith EP (1998) Pediatric endocrinology update: an overview. The essential roles of estrogens in pubertal growth, epiphyseal fusion and bone turnover: lessons from mutations in the gene for aromatase and the estrogen receptor. Horm Res 49:2–8CrossRefGoogle Scholar
  72. Marrakchi A, Belhaj L, Boussouf H, Chraibi A, Kadiri A (2005) Pure gonadal dysgenesis XX and XY: observations in 15 patients. Ann Endocrinol (Paris) 66:553–556CrossRefGoogle Scholar
  73. Marshall FF, Jeffs RD, Sarafyan WK (1979) Urogenital sinus abnormalities in the female patient. J Urol 122:568–572PubMedCrossRefGoogle Scholar
  74. McLorie GA, Sheldon CA, Fleisher M, Churchill BM (1987) The genitourinary system in patients with imperforate anus. J Pediatr Surg 22:1100–1104PubMedCrossRefGoogle Scholar
  75. Merguerian PA, McLorie GA (1992) Disorders of the female genitalia. In: Kelalis PP, King LR, Belman AB (eds) Clinical pediatric urology, 3rd edn. Saunders, Philadelphia, pp 1084–1105Google Scholar
  76. Metts JC, Kotkin L, Kasper S, Shyr Y, Adams MC, Brock JW (1997) Genital malformations and coexistent urinary tract or spinal anomalies in patients with imperforate anus. J Urol 158:1298–1300PubMedCrossRefGoogle Scholar
  77. Meyer JS, Harmon CM, Harty MP et al (1995) Ovarian torsion: clinical and imaging presentation in children. J Pediatr Surg 30:1433–1436PubMedCrossRefGoogle Scholar
  78. Minutoli F, Blandino A, Gaeta M, Lentini M, Pandolfo I (2001) Twisted ovarian fibroma with high signal intensity on T1-weighted MR image: a new sign of torsion of ovarian tumors? Eur Radiol 11:1151–1154PubMedCrossRefGoogle Scholar
  79. Moore KL, Persaud TVN, Mark GT (2011) The developing human: clinically oriented embryology, 9th edn. W.B. Saunders Company, PhiladelphiaGoogle Scholar
  80. Moshiri M, Chapman T, Fechner PY, Dubinsky TJ, Shnorhavorian M, Osman S, Bhargava P, Katz DS (2012) Evaluation and management of disorders of sex development: multidisciplinary approach to a complex diagnosis. Radiographics 32:1599–1618PubMedCrossRefGoogle Scholar
  81. Müller-Leisse C, Bick U, Paulussen K et al (1992) Ovarian cysts in the fetus and neonate: changes in sonographic pattern in the follow-up and their management. Pediatr Radiol 22:395–400PubMedCrossRefGoogle Scholar
  82. New MI (2003) Inborn errors of adrenal steroidogenesis. Mol Cell Endocrinol 211:75–83PubMedCrossRefGoogle Scholar
  83. Nidecker AC, Humphry A (1978) Peritoneal calcification in a neonate with imperforate hymen. J Can Assoc Radiol 29:277–279PubMedGoogle Scholar
  84. Nievelstein RAJ, Van der Werff JFA, Verbeek FJ, Valk J, Vermeij-Keers C (1998) Normal and abnormal embryonic development of the anorectum in human embryos. Teratology 57:70–78PubMedCrossRefGoogle Scholar
  85. Nussbaum AR, Sanders RC, Hartman DS, Dudgeon DL, Parmley TH (1988) Neonatal ovarian cysts: sonographic-pathologic correlation. Radiology 168:817–821PubMedCrossRefGoogle Scholar
  86. Oelsner G, Shashar D (2006) Adnexal torsion. Clin Obstet Gynecol 49(3):459–463PubMedCrossRefGoogle Scholar
  87. Orazi C, Lucchetti MC, Schingo PMS, Marchetti P, Ferro F (2007) Herlyn-Werner-Wunderlich syndrome: uterus didelphys, blind hemivagina and ipsilateral renal agenesis. Sonographic and MR findings in 11 cases. Pediatr Radiol 37:657–665PubMedCrossRefGoogle Scholar
  88. Orazi C, Silveri M, Cappa M, Bizarri C, Schingo PMS, Toma P (2012) Disorders of sexual development: role of imaging. Oral presentation at the 49th meeting of the European Society of Pediatric Radiology, Athens, 2012 MayGoogle Scholar
  89. Ording-Müller LS (2015) Paediatric urogenital radiology – ovarian torsion. Pediatr Radiol 45(S2):S309–S310Google Scholar
  90. Patel M, Racadio JM, Levitt MA, Bischoff A, Racadio JM, Peña A (2011) Complex cloacal malformations: use of rotational fluoroscopy and 3-D reconstruction in diagnosis and surgical planning. Pediatr Radiol 42:355–363PubMedCrossRefGoogle Scholar
  91. Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH (1992) Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiology 183:795–800PubMedCrossRefGoogle Scholar
  92. Pena A, Kessler O (1998) Posterior cloaca: a unique defect. J Pediatr Surg 33:407–412PubMedCrossRefGoogle Scholar
  93. Peña JE, Ufberg D, Cooney N et al (2000) Usefulness of Doppler sonography in the diagnosis of ovarian torsion. Fertil Steril 73:1047–1050PubMedCrossRefGoogle Scholar
  94. Rathke H (1882) Abhandlung zur Bildungsgeschichte der Tiere. LeipzigGoogle Scholar
  95. Retterer E (1890) Sur l’origine et l’évolution de la région anogénitale des mammifères. J Anat Physiol 26:126–216Google Scholar
  96. Rha SE, Byun JY, Jung SE, Jung JI, Choi BG, Kim BS, Kim H, Lee JM (2002) CT and MR imaging features of adnexal torsion. Radiographics 22:283–294PubMedCrossRefGoogle Scholar
  97. Riccabona M (2013) Imaging of the neonatal female pelvis. Pediatr Radiol 43(Suppl3):S496Google Scholar
  98. Riccabona M, Lobo ML, Willi U, Avni F, Damasio B, Ording-Mueller LS, Blickman J, Darge K, Papadopoulou F, Vivier PH (2014) ESPR uroradiology task force and ESUR Paediatric Work Group—Imaging recommendations in paediatric uroradiology, part VI: childhood renal biopsy and imaging of neonatal and infant genital tract. Pediatr Radiol 44:496–502PubMedCrossRefGoogle Scholar
  99. Riccabona M, Darge K, Lobo ML, Ording-Muller LS, Augdal TA, Avni FE, Blickman J, Damasio BM, Ntoulia A, Papadopoulou F, Vivier PH, Willi U (2015) ESPR Uroradiology Task Force – Imaging Recommendations in Paediatric Uroradiology – Part VIII: Rethrograde urethrography, imaging in disorders of sexual development, and imaging in childhood testicular torsion. Report on the mini-symposium at the ESPR meeting in Amsterdam, June 2014. Pediatr Radiol 45:2023–8PubMedPubMedCentralCrossRefGoogle Scholar
  100. Riccabona M, Lobo ML, Ording-Muller LS, Augdal ThA, Vivier PH, Avni FE, Blickman J, Damasio BM, Darge K, Ntoulia A, Papadopoulou F, Willi U (2017) ESPR abdominal (GU and GI) imaging Task Force – Imaging Recommendations in Paediatric Uroradiology – Part IX: imaging in anorectal and cloacal malformation, imaging in childhood ovarian torsion, and efforts in standardising pediatric uroradiology terminology. Report on the mini-symposium at the ESPR meeting in Graz, June 2015. Pediatr Radiol 47:1369-1380. doi:  10.1007/s00247-017-3837-6. Epub 2017 Aug 29CrossRefPubMedPubMedCentralGoogle Scholar
  101. Rich MA, Brock WA, Pena A (1988) Spectrum of genitourinary malformations in patients with imperforate anus. Pediatr Surg Int 3:110–113Google Scholar
  102. Rieth KG, Comite F, Shawker TH, Cutler GB (1981) Pituitary and ovarian abnormalities demonstrated by CT and ultrasound in children with features of McCune-Albright syndrome. Radiology 153:389–393CrossRefGoogle Scholar
  103. Rosenberg HK, Sherman NH, Tarry WF, Duckett JW, McCrum Snyder H (1986) Mayer-Rokitansky-Kuster-Hauser syndrome: US aid to diagnosis. Radiology 161:815–819PubMedCrossRefGoogle Scholar
  104. Rosenblatt M, Rosenblatt R, Kutcher R, Coupey SM, Kleinhaus S (1991) Utero-vaginal hypoplasia. Pediatr Radiol 21:536–537PubMedCrossRefGoogle Scholar
  105. Rosenfeld DL, Lis E (1993) Gartner’s duct cyst with single vaginal ectopic ureter and associated renal dysplasia or agenesis. J Ultrasound Med 12:775–778PubMedCrossRefGoogle Scholar
  106. Shozu M, Akasofu K, Harda T, Kubota Y (1991) A new cause of female pseudohermaphrodism: placental aromatase deficiency. J Clin Endocrinol Metab 72:560–566PubMedCrossRefGoogle Scholar
  107. Servaes S, Victoria T, Lovrenski J, Epelman M (2010) Contemporary pediatric gynecologic imaging. Semin Ultrasound CT MR 31:116–140PubMedCrossRefGoogle Scholar
  108. Servaes S, Zurakowski D, Laufer MR, Feins N, Chow JS (2007) Sonographic findings of ovarian torsion in children. Pediatr Radiol 37:446–451PubMedCrossRefGoogle Scholar
  109. Siegel MJ (2011) Pediatric sonography, 4th edn. Wolters Kluwer/Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  110. Silverman FN, Kuhn JP (2013) Caffey’s pediatric X-ray diagnosis: an integrated imaging approach, 12th edn. Elsevier Saunders, PhiladelphiaGoogle Scholar
  111. Stephens FD (1983a) Normal embryology of the cloaca. In: Stephens FD (ed) Congenital malformation of the urinary tract. Praeger, New York, pp 1–14Google Scholar
  112. Stephens FD (1983b) Abnormal embryology-cloacal dysgenesis. In: Stephens FD (ed) Congenital malformation of the urinary tract. Praeger, New York, pp 15–52Google Scholar
  113. Taybi H, Lachman RS (2007) Radiology of syndromes, metabolic disorders, and skeletal dysplasias, 5th edn. Mosby, St. LouisGoogle Scholar
  114. Teele RL, Share JC (1991) Ultrasonography of infants and children. Saunders, Philadelphia, pp 240–244Google Scholar
  115. Teele RL, Share JC (1992) Ultrasonography of the female pelvis in childhood and adolescence. Radiol Clin North Am 30:743–758PubMedGoogle Scholar
  116. Teele RL, Share JC (1997) Transperineal sonography in children. AJR Am J Roentgenol 168:1263–1267PubMedCrossRefGoogle Scholar
  117. Togashi K (2003) MR imaging of the ovaries: normal appearance and benign disease. Radiol Clin North Am 41:799–811PubMedCrossRefGoogle Scholar
  118. Tokgoz H, Turksoy O, Boyacigil S, Sakman B, Yuksel E (2006) Complete androgen insensitivity syndrome: report of a case with solitary pelvic kidney. Acta Radiol 47:222–225PubMedCrossRefGoogle Scholar
  119. Topaloglu AK, Vade A, Zeller WP (1997) Congenital adrenal hyperplasia and bilateral ovarian cysts in a neonate. Clin Pediatr (Phila) 36:719–720CrossRefGoogle Scholar
  120. Tolete-Velcek F, Hansbrough F, Kugaczewski J, Coren CV, Klotz DH, Price AF, Laungani G, Kottmeier PK (1989) Uterovaginal malformations: a trap for the unsuspecting surgeon. J Pediatr Surg 24:736–740PubMedCrossRefGoogle Scholar
  121. Tourneux F (1888) Sur les premiers développements du cloaques du tubercule génital et de l’anus chez l’embryon de mouton. J Anat 24:503–517Google Scholar
  122. Unsinn KM, Neu N, Krejci A, Posch A, Menardi G, Gassner I (1995) Pallister-Hall syndrome and McKusick-Kaufmann syndrome: one entity? J Med Genet 32:125–128PubMedPubMedCentralCrossRefGoogle Scholar
  123. Van Bogaert LJ (1992) Surgical repair of hypospadias in women with symptoms of urethral syndrome. J Urol 147:1263–1264PubMedCrossRefGoogle Scholar
  124. Van der Putte SCJ (1986) Normal and abnormal development of the anorectum. J Pediatr Surg 24:434–440CrossRefGoogle Scholar
  125. Vijayaraghavan SB (2004) Sonographic whirlpool sign in ovarian torsion. J Ultrasound Med 23:1643–1649PubMedCrossRefGoogle Scholar
  126. Wagner BJ, Woodward P (1994) Magnetic resonance evaluation of congenital uterine anomalies. Semin Ultrasound CT MR 15:4–17PubMedCrossRefGoogle Scholar
  127. Willi UV (1991) Pediatric genitourinary imaging. Curr Opin Radiol 3:936–945PubMedGoogle Scholar
  128. Williams DJ, Bloomberg S (1976) Urogenital sinus in the female child. J Pediatr Surg 11:51–56PubMedCrossRefGoogle Scholar
  129. Wilson JD, Goldstein JL (1975) Classification of hereditary disorders of sexual development. Birth Defects Orig Artic Ser 11:1–16PubMedGoogle Scholar
  130. Woolf RB, Allen WM (1953) Concomitant malformations: the frequent simultaneous occurrence of congenital malformations of the reproductive and urinary tracts. Obstet Gynecol 2:236–265PubMedGoogle Scholar
  131. Ziereisen F, Guissard G, Damry N, Avni EF (2005) Sonographic imaging of the paediatric female pelvis. Eur Radiol 15:1296–1309PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Gisela Schweigmann
    • 1
  • Theresa E. Geley
    • 1
  • Ingmar Gassner
    • 1
  1. 1.Section of Pediatric RadiologyMedical University of InnsbruckInnsbruckAustria

Personalised recommendations