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Evaluation of Mayer-Rokitansky-Küster-Hauser syndrome with magnetic resonance imaging: Three patterns of uterine remnants and related anatomical features and clinical settings

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Abstract

Objective

To characterize the anatomical features and clinical settings of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and correlate them with patterns of uterine involvement.

Methods

Pelvic magnetic resonance images and medical records of 92 MRKH patients were retrospectively reviewed. Patients were subgrouped by uterine morphology: uterine agenesis, unilateral rudimentary uterus and bilateral rudimentary uteri. Uterine volume, presence of endometrium, location of ovary, endometriosis and pelvic pain were compared among groups.

Results

The mean uterine volume was 33.5 ml (17.5–90.0 ml) for unilateral uterine remnants, and 16.1 ml (3.5–21.5 ml) for bilateral uterine rudiments (p<0.01). The incidence of presence of endometrium (100% vs. 22%, p<0.001), haematometra (56% vs. 3%, p<0.001) and ovarian endometriosis (22% vs. 3%, p<0.01) was significantly increased in the group of unilateral rudimentary uteri as compared with the group of bilateral uterine remnants. Thirty-one patients (38%) showed ectopic ovaries. Pelvic pain was more common in individuals with unilateral rudimentary uterus than those who had no (56% vs. 5%, p<0.01) or bilateral uterine remnants (56% vs. 14%, p<0.05).

Conclusion

MRKH patients with different patterns of uterine involvement may have differentiated anatomical features and clinical settings.

Key Points

• Rudimentary uteri, especially bilateral rudimentary uteri, were quite common in MRKH syndrome.

• Uterine remnants can be relatively large, especially the unilateral rudimentary uterus.

• Presence of endometrium and related complications are not rare in MRKH syndrome.

• Existence of endometrium and complications are more frequent in unilateral rudimentary uterus.

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Abbreviations

MRKH:

Mayer-Rokitansky-Küster-Hauser syndrome

MRI:

Magnetic resonance imaging

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Acknowledgements

An abstract containing similar content was accepted for oral presentation at ECR 2017

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Authors and Affiliations

  1. Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Wangfujing Street, Dongcheng District, Beijing, 100730, People’s Republic of China

    Yue Wang, Jingjing Lu, Bo Jiang, Feng Feng & Zhengyu Jin

  2. Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Wangfujing Street, Dongcheng District, Bejing, 100730, People’s Republic of China

    Lan Zhu & Zhijing Sun

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  1. Yue Wang
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  2. Jingjing Lu
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  3. Lan Zhu
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  4. Zhijing Sun
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  5. Bo Jiang
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  6. Feng Feng
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Corresponding authors

Correspondence to Jingjing Lu or Lan Zhu.

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Guarantor

The scientific guarantor of this publication is Prof. Jingjing Lu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

The study was funded by the ‘Excellent Talents of Beijing Dongcheng District program, year 2012 and year 2015’.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Wang, Y., Lu, J., Zhu, L. et al. Evaluation of Mayer-Rokitansky-Küster-Hauser syndrome with magnetic resonance imaging: Three patterns of uterine remnants and related anatomical features and clinical settings. Eur Radiol 27, 5215–5224 (2017). https://doi.org/10.1007/s00330-017-4919-4

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  • DOI: https://doi.org/10.1007/s00330-017-4919-4

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