Objectives
The aim of this study was to evaluate the accuracy of preoperative magnetic resonance imaging (MRI) in the diagnosis of malformations associated with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and identification of uterine endometrium to optimise the clinical management.
Methods
We retrospectively reviewed 214 consecutive MRKH patients, mean age 19 years, who underwent laparoscopy-assisted neovagina creation. A total of 115 patients (53.7 %) met the inclusion criterion of sufficient preoperative MRI. In 110 of them (95.7 %), MRI findings were correlated with laparoscopy and associated malformations. In 39 cases (35.5 %) uterine rudiments were removed and analysed histopathologically.
Results
Ten per cent (11/110) of the patients showed complete uterine agenesis. The others presented with either unilateral (n = 16; 14.5 %) or bilateral (n = 83; 75.5 %) uterine rudiments. MRI detection of uterine rudiments agreed in 78.2 % (86/110) with laparoscopy. In 85.4 % of the removed rudiments, MRI could correctly diagnose the existence of the endometrium. Compared to laparoscopy, MRI could exactly detect ovaries in 97.3 % (107/110). Renal or ureteral malformations were seen in 32 cases (27.8 %). In 83 % of unilateral renal agenesis and unilateral rudiment, the latter was located at the side of the kidney.
Conclusions
MRI is useful for preoperative detection of MRKH-associated malformations and assessment of the endometrium to further optimise MRKH patient treatment.
Key points • Pelvic MRI is useful for preoperative detection of MRKH-associated malformations.
• MRI can diagnose uterine endometrium in MRKH patients with high precision.
• Preoperative MRI can optimise clinical management of patients with MRKH syndrome.