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Pregnancy in a rudimentary horn: multicenter’s MRI features of a rare condition

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Abstract

Purpose

To describe the MRI features of rudimentary horn pregnancy (RHP) with surgical correlations.

Methods

Nine women with a RHP underwent preoperative pelvic MRI. MRI protocol included T2- (n = 9), T1- (n = 7), and fat-suppressed contrast-enhanced T1-weighted sequences (n = 4). Two pelvic radiologists retrospectively analyzed MR images to assess the following MRI features: presence of a myometrium around the gestational sac (GS) and characteristics of its wall, GS surrounded by myometrium in contact with the round ligament, communication of the GS with the endometrial cavity of the main horn, continuity of the GS with the cervix, fibrous or muscular GS attachment to the main horn, lateral deviation, and endometrial thickness of the main horn. Ovaries and tubes were also assessed. MRI features were correlated with surgical findings.

Results

Seven of the nine women [29 ± 6 SD years (range 16–37 years)] underwent surgical management. The first US diagnosed RHP in only 1/9 patients. All pregnancies were diagnosed using MRI. RHP was all located in the rudimentary horn of a unicornuate uterus. All the GS was surrounded by myometrium in contact with the round ligament. None of the RHP displayed communication with the endometrial cavity of the main horn nor with the cervix. An attachment between the RHP and the main horn was seen in 3/9 patients. All the main horns were lateralized and empty.

Conclusion

MRI diagnosed RHP in all patients by identifying the GS surrounded by myometrium in contact with the round ligament and the absence of continuity between the GS and the cervix.

Level of evidence

IV—retrospective study.

Graphical abstract

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Acknowledgements

We would like to thank Dr N. MAINARD for his precious advice in the elaboration of this work

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

  1. Department of Women Imaging, Hospital Center of Valenciennes, Avenue Désandrouin, 59322, Valenciennes Cedex, France

    Blandine Hamet

  2. Department of Radiology, Robert-Debré Hospital, CHU Reims, rue du Général-Kœnig, 51100, Reims, France

    Christine Hoeffel

  3. Department of Gynecological Surgery, Hospital Centre of Valenciennes, Avenue Désandrouin, 59322, Valenciennes Cedex, France

    Vassili Fague

  4. Department of Gynecological Surgery, Hospital Saint Vincent de Paul, Boulevard de Belfort, 59000, Lille, France

    Jean-Philippe Lucot

  5. Department of Medical Imaging, CHU Montpellier, Hospital Lapeyronie, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France

    Emmanuelle Pagès-Bouic

  6. Medical and Interventional Imaging Department, Lyon Sud Hospital, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite, France

    Pascal Rousset

  7. Department of Gynecology and Obstetrics, Hôpital Maison Blanche, CHU Reims, 45 rue Cognacq Jay, 51092, Reims, France

    Olivier Graesslin

  8. Department of Radiology, Tenon University Hospital, 4 Rue de la Chine, 75020, Paris, France

    Marc Bazot

  9. Department of Women Imaging,, Hospital Center of Valenciennes, Avenue Désandrouin, 59322, Valenciennes, France

    Edouard Poncelet

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  1. Blandine Hamet
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  2. Christine Hoeffel
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  3. Vassili Fague
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  8. Marc Bazot
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  9. Edouard Poncelet
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Contributions

BH involved in writing—original draft. CH involved in review & editing, supervision, and validation. VF, OG, EP, PR, MB, and J-PL involved in resources and review & editing. EP involved in writing—review & editing, supervision, and validation.

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Correspondence to Blandine Hamet.

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Hamet, B., Hoeffel, C., Fague, V. et al. Pregnancy in a rudimentary horn: multicenter’s MRI features of a rare condition. Abdom Radiol 47, 4195–4204 (2022). https://doi.org/10.1007/s00261-022-03658-3

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  • DOI: https://doi.org/10.1007/s00261-022-03658-3

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