Fehlbildungen der Gebärmutter

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.
Wikipedia • CC BY-SA 4.0
Uterus
subseptus in der Computertomographie links axial und rechts in der Ebene des Uterus rekonstruiert. Zusätzlich zystischer Tumor mit abgebildet.
Wikipedia • CC BY-SA 3.0
Accessory and
cavitated uterine mass (ACUM)- A rare Mullerian anomaly. STIR axial image showing thick-walled lesion contiguous with the left lateral uterine wall.
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.
www.eurorad.org • CC by-nc-sa-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

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
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