Jared Whiting Allen MD, PhD, Presenter: Nothing to Disclose

Seth Cardall MD, Abstract Co-Author: Nothing to Disclose

Mayuree Kittijarukhajorn MD, Abstract Co-Author: Nothing to Disclose

Cary Lynn Siegel MD, Abstract Co-Author: Nothing to Disclose

To evaluate the incidence of ovarian maldescent in patients with and without müllerian duct anomalies

This HIPPA-compliant, IRB approved study retrospectively reviewed 129 female patients (mean age 28.1 ± 8.7 years old) who underwent pelvic MRI between 2002 –2010. Multiplanar MRI exams of patients with (n=65) and without (n= 64) congenital uterine anomalies were evaluated for ovarian size, position, follicle count, and associated renal anomalies. Patients with pregnancy, known prior pelvic surgery, or large uterine leiomyomas were excluded. Two methods were employed to determine ovarian position: ovarian upper pole above the iliac bifurcation or above the pelvic brim, as defined by the pubic symphysis – sacral promontory line.

A full spectrum of müllerian duct anomalies was identified: didelphys = 10, bicornuate = 2, unicornuate = 12, septate (complete or partial) = 29, partial agenesis = 9, other = 3. Ovarian maldescent was identified in 30/65 (45%) of women with uterine anomalies as compared to 14/64 (22%) in those without (P < 0.005, Chi –squared test). Patients with didelphys, bicornuate, or unicornuate had a higher incidence of maldescent (17/24, 71%) than the septate uterus subgroup (8/29, 28%), the latter of which is not significantly different from the incidence among those with normal uterine anatomy. In all patients with unicornuate uterus and maldescent, the ovary on the same side as the undeveloped horn was involved. Ovarian size and follicle count was not significantly different in the two groups. Renal anomalies were present in 16/65 patients, the majority of which had concomitant ovarian maldescent (11/16, P < 0.05).

There is increased incidence of ovarian maldescent in patients with müllerian duct anomalies, with the highest association in those with more severe fusion anomalies (i.e. didelphys, bicornuate, unicornuate).

Awareness of ovarian position is important in the management of pelvic pain, infertility treatment, surgical planning, and differentiating other peritoneal pathology.

Allen, J, Cardall, S, Kittijarukhajorn, M, Siegel, C, Ovarian Maldescent in Women with Müllerian Duct Anomalies: Evaluation by Pelvic MRI.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9005315.html