MRI Imaging of Septate Uterus
A septate uterus occurs when the septum of the fused müllerian ducts fails to absorb. The residual septum ranges from complete to partial and consists of fibrous tissue,myometrium, or both. Because the müllerian ducts have already fused, the external uterine surface is normal, distinguishing this abnormality from a bicornuate uterus.
Magnetic resonance imaging is helpful in identifying this condition. Nevertheless, both US and MRI most often misdiagnose a septate uterus as either a normal or bicornuate uterus. The MR septal signal intensity varies depending on its composition and often is not a reliable indicator in differentiating a septate from a bicornuate uterus; on T2- weighted images a fibrous septum is seen as a hypointense region, while a myometrial septum has a signal intensity similar to myometrium. Generally hysteroscopic metroplasty is performed for a septate uterus,with preservation of future vaginal delivery.
Magnetic resonance imaging is helpful in identifying this condition. Nevertheless, both US and MRI most often misdiagnose a septate uterus as either a normal or bicornuate uterus. The MR septal signal intensity varies depending on its composition and often is not a reliable indicator in differentiating a septate from a bicornuate uterus; on T2- weighted images a fibrous septum is seen as a hypointense region, while a myometrial septum has a signal intensity similar to myometrium. Generally hysteroscopic metroplasty is performed for a septate uterus,with preservation of future vaginal delivery.
This is radiology images of the septate uterus. Transverse T2–weighted image identifies a septum in the uterine cavity (arrow). The external uterine outline is normal.
Radiology images of the septate uterus (arrow) identified on T2-weighted transverse oblique MR image
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