Malformationen des Uterus

Uterus bicornis bicollis mit gemeinsamer Portioöffnung: Das Cavum uteri ist vollständig getrennt, es gibt aber noch gemeinsames Myometrium (sonst Uterus didelphys); Septum in nahezu der kompletten Zervix. MRT T2, links 2 Schichten paracoronar, rechts 3 Schichten axial in verschiedenen Höhen.

Uterus

bicornis bicollis mit gemeinsamer Portioöffnung: Das Cavum uteri ist vollständig getrennt, es gibt aber noch gemeinsames Myometrium (sonst Uterus didelphys); Septum in nahezu der kompletten Zervix. MRT T2, links 2 Schichten paracoronar, rechts 3 Schichten axial in verschiedenen Höhen.

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Renal agenesis • Unilateral renal agenesis and class II Mullerian duct anomaly - Ganzer Fall bei Radiopaedia

Renal

agenesis • Unilateral renal agenesis and class II Mullerian duct anomaly - Ganzer Fall bei Radiopaedia

Babu, V. Unilateral renal agenesis and class II Mullerian duct anomaly. Case study, Radiopaedia.org. (accessed on 22 Oct 2022) https://doi.org/10.53347/rID-59008 • CC by-nc-sa 3.0 (modified)

Mature cystic ovarian teratoma • Septate uterus with ovarian pathologies - Ganzer Fall bei Radiopaedia

Mature cystic

ovarian teratoma • Septate uterus with ovarian pathologies - Ganzer Fall bei Radiopaedia

Yang N, Septate uterus with ovarian pathologies. Case study, Radiopaedia.org (Accessed on 14 Apr 2024) https://doi.org/10.53347/rID-6978 • CC by-nc-sa 3.0 (modified)

Uterus • Uterine anatomical abnormalities (illustrations) - Ganzer Fall bei Radiopaedia

Uterus •

Uterine anatomical abnormalities (illustrations) - Ganzer Fall bei Radiopaedia

Gaillard F, Uterine anatomical abnormalities (illustrations). Case study, Radiopaedia.org (Accessed on 14 Apr 2024) https://doi.org/10.53347/rID-11115 • CC by-nc-sa 3.0 (modified)

The clinical relevance of anatomical variants!. The distal third of the two hemivaginas (arrows) separated by a band of fibrous tissue (arrowhead); the obstructed right hemivagina is already dilated, containing heterogeneous debris, which indicates distal obstruction.

The clinical

relevance of anatomical variants!. The distal third of the two hemivaginas (arrows) separated by a band of fibrous tissue (arrowhead); the obstructed right hemivagina is already dilated, containing heterogeneous debris, which indicates distal obstruction.

www.eurorad.org • CC by-nc-sa-4.0

Accessory and cavitated uterine mass (ACUM)- A rare Mullerian anomaly. STIR axial image showing thick-walled lesion contiguous with the left lateral uterine wall.

Accessory and

cavitated uterine mass (ACUM)- A rare Mullerian anomaly. STIR axial image showing thick-walled lesion contiguous with the left lateral uterine wall.

www.eurorad.org • CC by-nc-sa-4.0

Accessory and cavitated uterine mass (ACUM)- A rare Mullerian anomaly. T1 fat suppressed axial image shows bright signal in the central part of the lesion consistent with signal intensity of blood degradation products.

Accessory and

cavitated uterine mass (ACUM)- A rare Mullerian anomaly. T1 fat suppressed axial image shows bright signal in the central part of the lesion consistent with signal intensity of blood degradation products.

www.eurorad.org • CC by-nc-sa-4.0

Müllerian duct anomalies • Müllerian duct development - Gray's anatomy illustration - Ganzer Fall bei Radiopaedia

Müllerian

duct anomalies • Müllerian duct development - Gray's anatomy illustration - Ganzer Fall bei Radiopaedia

Illustrations G, Müllerian duct development - Gray's anatomy illustration. Case study, Radiopaedia.org (Accessed on 24 Jan 2023) https://doi.org/10.53347/rID-36424 • CC by-nc-sa 3.0 (modified)

Septate uterus • Uterine anatomical abnormalities (illustrations) - Ganzer Fall bei Radiopaedia

Septate

uterus • Uterine anatomical abnormalities (illustrations) - Ganzer Fall bei Radiopaedia

Gaillard F, Uterine anatomical abnormalities (illustrations). Case study, Radiopaedia.org (Accessed on 18 Jan 2023) https://doi.org/10.53347/rID-11115 • CC by-nc-sa 3.0 (modified)

Müllerian duct anomalies • Bicornuate uterus with solitary kidney - Ganzer Fall bei Radiopaedia

Müllerian

duct anomalies • Bicornuate uterus with solitary kidney - Ganzer Fall bei Radiopaedia

Desai P, Bicornuate uterus with solitary kidney. Case study, Radiopaedia.org (Accessed on 24 Jan 2023) https://doi.org/10.53347/rID-10048 • CC by-nc-sa 3.0 (modified)

Uterine duplication anomalies • Septate uterus with ovarian pathologies - Ganzer Fall bei Radiopaedia

Uterine

duplication anomalies • Septate uterus with ovarian pathologies - Ganzer Fall bei Radiopaedia

Yang N, Septate uterus with ovarian pathologies. Case study, Radiopaedia.org (Accessed on 28 Dec 2022) https://doi.org/10.53347/rID-6978 • CC by-nc-sa 3.0 (modified)

Müllerian duct anomalies • Unicornuate uterus with renal anomaly - Ganzer Fall bei Radiopaedia

Müllerian

duct anomalies • Unicornuate uterus with renal anomaly - Ganzer Fall bei Radiopaedia

Hartung M, Unicornuate uterus with renal anomaly. Case study, Radiopaedia.org (Accessed on 24 Jan 2023) https://doi.org/10.53347/rID-59557 • CC by-nc-sa 3.0 (modified)

Uterine duplication anomalies • Bicornuate uterus with triamniotic dichorionic triplet pregnancy (3D ultrasound) - Ganzer Fall bei Radiopaedia

Uterine

duplication anomalies • Bicornuate uterus with triamniotic dichorionic triplet pregnancy (3D ultrasound) - Ganzer Fall bei Radiopaedia

Fares G, Bicornuate uterus with triamniotic dichorionic triplet pregnancy (3D ultrasound). Case study, Radiopaedia.org (Accessed on 28 Dec 2022) https://doi.org/10.53347/rID-97799 • CC by-nc-sa 3.0 (modified)

Unicornuate uterus • Unicornuate uterus (3D ultrasound) - Ganzer Fall bei Radiopaedia

Unicornuate

uterus • Unicornuate uterus (3D ultrasound) - Ganzer Fall bei Radiopaedia

Fares G, Unicornuate uterus (3D ultrasound). Case study, Radiopaedia.org (Accessed on 24 Jan 2023) https://doi.org/10.53347/rID-98572 • CC by-nc-sa 3.0 (modified)

The clinical relevance of anatomical variants!. Sagittal transabdominal US image shows an elliptical echogenic mass, which represents the vaginal cavity markedly distended with blood products (haematocolpos). The uterus extends from the superior aspect of the mass.

The clinical

relevance of anatomical variants!. Sagittal transabdominal US image shows an elliptical echogenic mass, which represents the vaginal cavity markedly distended with blood products (haematocolpos). The uterus extends from the superior aspect of the mass.

www.eurorad.org • CC by-nc-sa-4.0

The clinical relevance of anatomical variants!. Transverse transabdominal US image shows uterus didelphys, with two uterine horns and two separated endometrial cavities.

The clinical

relevance of anatomical variants!. Transverse transabdominal US image shows uterus didelphys, with two uterine horns and two separated endometrial cavities.

www.eurorad.org • CC by-nc-sa-4.0

The clinical relevance of anatomical variants!. MR image shows a dilated hemivagina whose content has signal characteristics of blood, forming a blind-ending pouch secondary to obstruction.

The clinical

relevance of anatomical variants!. MR image shows a dilated hemivagina whose content has signal characteristics of blood, forming a blind-ending pouch secondary to obstruction.

www.eurorad.org • CC by-nc-sa-4.0

The clinical relevance of anatomical variants!. A large haematocolpos centrally (arrow), a finding that corresponds to the obstructed right hemivagina. Mild dilatation of the right endometrial cavity and a nondistended left endometrial cavity are also seen.

The clinical

relevance of anatomical variants!. A large haematocolpos centrally (arrow), a finding that corresponds to the obstructed right hemivagina. Mild dilatation of the right endometrial cavity and a nondistended left endometrial cavity are also seen.

www.eurorad.org • CC by-nc-sa-4.0

The clinical relevance of anatomical variants!. Coronal T2-weighted image of a uterus didelphys, obtained in plane with the uterus, shows two widely divergent uterine horns (arrows) separated by a deep fundal cleft.

The clinical

relevance of anatomical variants!. Coronal T2-weighted image of a uterus didelphys, obtained in plane with the uterus, shows two widely divergent uterine horns (arrows) separated by a deep fundal cleft.

www.eurorad.org • CC by-nc-sa-4.0

The clinical relevance of anatomical variants!. Coronal fast spin-echo T2-WI shows a solitary left kidney, confirming renal agenesis with bowel loops in the right renal fossa, which is ipsilateral to the obstructed hemivagina.

The clinical

relevance of anatomical variants!. Coronal fast spin-echo T2-WI shows a solitary left kidney, confirming renal agenesis with bowel loops in the right renal fossa, which is ipsilateral to the obstructed hemivagina.

www.eurorad.org • CC by-nc-sa-4.0

The clinical relevance of anatomical variants!. Transverse oblique T2-WI obtained with fat suppression demonstrate communication of the right uterine horn (curved arrow) with the dilated left hemivagina (arrow); the appearance of the left uterine horn is normal.

The clinical

relevance of anatomical variants!. Transverse oblique T2-WI obtained with fat suppression demonstrate communication of the right uterine horn (curved arrow) with the dilated left hemivagina (arrow); the appearance of the left uterine horn is normal.

www.eurorad.org • CC by-nc-sa-4.0

Müllerian duct anomalies • Mayer-Rokitansky-Küster-Hauser syndrome - Ganzer Fall bei Radiopaedia

Müllerian

duct anomalies • Mayer-Rokitansky-Küster-Hauser syndrome - Ganzer Fall bei Radiopaedia

Rasuli B, Mayer-Rokitansky-Küster-Hauser syndrome. Case study, Radiopaedia.org (Accessed on 21 Apr 2024) https://doi.org/10.53347/rID-183001 • CC by-nc-sa 3.0 (modified)

Radiopaedia • CC-by-nc-sa 3.0 • de

siehe auch

Uterus
Uterus didelphys
Müllerian duct anomaly classification
Uterus arcuatus
Uterus septus
Müller-Gang
Uterus bicornis
Mayer-Rokitansky-Küster-Hauser syndrome
Uterus unicornis
transverses Vaginalseptum
obstruierte Hemivagina und ipsilaterale renale Anomalie (OHVIRA) Syndrom
Vaginalseptum
Müller-Gang-Persistenzsyndrom
Duplikatur des Uterus
Uterusagenesie
class IV Mullerian duct anomaly

There are many classification systems for congenital utero-vaginal anomalies. These include:

Buttram and Gibbons classification
American Fertility Society (AFS) classification
Modified Rock and Adam - AFS classification

Modified Rock and Adam - AFS classification

This classification divides congenital uterine anomalies into four main types:

class I: dysgenesis of Müllerian ducts
- includes agenesis or hypoplasia of the müllerian duct derivatives: the uterus and upper two-thirds of the vagina
- the most common form is the Mayer-Rokitansky-Kuster-Hauser syndrome which is the combined agenesis of the uterus, cervix, and upper portion of the vagina
class II: disorders of vertical fusion
- these anomalies are due to failure of fusion of the müllerian system with the sinovaginal bulb
- they include cervical dysgenesis and obstructive and nonobstructive transverse vaginal septa
class III: disorders of lateral fusion
- describes anomalies that result in a duplicated or partially duplicated reproductive tract
- these disorders are due to impaired fusion and/or septal resorption of fusing Müllerian ducts attempting to form the uterus, cervix, and upper vagina
- it includes anomalies due to failure of fusion of the paired müllerian ducts (as in didelphic and bicornuate uteri) and failure of midline septum resorption after fusion (as in septate uterus)
- disorders due to lateral fusion defects are further subclassified into
  - a: symmetric non-obstructive forms seen in five types: unicornuate, bicornuate, didelphic, septate, and DES-related uteri
  - b: asymmetric obstructive forms seen in three types: unicornuate uterus with obstructed horn, double uterus with unilaterally obstructed horn, and double uterus with unilaterally obstructed vagina
class IV: unusual configurations and combinations of defects