Paul David Humphries MBBS, Presenter: Nothing to Disclose

Jane Simpson, Abstract Co-Author: Nothing to Disclose

Sarah Creighton, Abstract Co-Author: Nothing to Disclose

Margaret Anne Hall-Craggs MD, Abstract Co-Author: Nothing to Disclose

Children with complex Müllerian anomalies now have improved survival rates necessitating surgical intervention to optimise sexual activity, menstruation and fertility. Our aim was to evaluate magnetic resonance imaging (MRI) in the assessment of the vagina in adolescent and young women with Müllerian anomalies to facilitate appropriate management.

Retrospective review and comparison of pelvic MRI with clinical/surgical assessment of adolescent and young women referred to a tertiary centre for the management of Müllerian anomalies between 1996 and 2004. Fifty one girls and young women (age range 12-36 years) underwent both MR imaging and clinical/surgical assessment. In each of these cases the vaginal appearances on MRI were compared with clinical/surgical findings.

Vaginal abnormalities were demonstrated in 33 patients. Five of these were postoperative examinations. The remaining 28 abnormal cases included double vaginas (9), segmental atresia (8), complete agenesis (9) and vaginal septae (2). The MRI findings correlated well with surgical assessment, with partial discordance seen with respect to the length of the vagina in 5 cases; this being most marked with very small clinically apparent vaginal remnants at the introitus.

Pelvic MRI can contribute to the assessment of the vagina in patients with developmental anomalies of the urogenital tract. It is particularly useful in younger patients who may not be sexually active and where more invasive techniques such as the use of intraluminal instruments or contrast is not appropriate. In our study correlation between MRI and clinical/surgical findings was good, although estimation of vaginal length was discrepant in some cases. MRI can contribute to vaginal assessment where there is distal vaginal atresia and clinical assessment is limited.

Children with complex Müllerian anomalies now have improved survival rates necessitating surgical intervention to optimise sexual activity, menstruation and fertility. Our aim was to evaluate magnetic resonance imaging (MRI) in the assessment of the vagina in adolescent and young women with Müllerian anomalies to facilitate appropriate management.

Retrospective review and comparison of pelvic MRI with clinical/surgical assessment of adolescent and young women referred to a tertiary centre for the management of Müllerian anomalies between 1996 and 2004. Fifty one girls and young women (age range 12-36 years) underwent both MR imaging and clinical/surgical assessment. In each of these cases the vaginal appearances on MRI were compared with clinical/surgical findings.

Vaginal abnormalities were demonstrated in 33 patients. Five of these were postoperative examinations. The remaining 28 abnormal cases included double vaginas (9), segmental atresia (8), complete agenesis (9) and vaginal septae (2). The MRI findings correlated well with surgical assessment, with partial discordance seen with respect to the length of the vagina in 5 cases; this being most marked with very small clinically apparent vaginal remnants at the introitus.

Pelvic MRI can contribute to the assessment of the vagina in patients with developmental anomalies of the urogenital tract. It is particularly useful in younger patients who may not be sexually active and where more invasive techniques such as the use of intraluminal instruments or contrast is not appropriate. In our study correlation between MRI and clinical/surgical findings was good, although estimation of vaginal length was discrepant in some cases. MRI can contribute to vaginal assessment where there is distal vaginal atresia and clinical assessment is limited.

Humphries, P, Simpson, J, Creighton, S, Hall-Craggs, M, Magnetic Resonance Assessment of the Vagina in Developmental Anomalies of the Female Genital Tract.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4414197.html