Magnetic resonance imaging in obstructive Müllerian anomalies
A 13-years-old female presented with a history of severe abdomino-pelvic pain, which increased with each of her menstrual cycles lasting 2–7 days. Gynecological history indicated menarche 3 months back. However, there was no abnormal vaginal bleeding, nausea, vomiting, or diarrhoea. A bimanual physical examination indicated a right-sided cystic and tender pelvic mass, movable, and mildly tender to palpation. Ultrasound showed the absence of right kidney, uterine didelphis, and a caudal cystic lesion with internal echogenicities adjacent to it [Figure and ]. Magnetic resonance imaging (MRI) was performed in order to evaluate the possible genito-urinary anomaly.\nMRI showed evidence of uterine didelphis, the left segment draining normally through a collapsed left hemivagina, and seen to communicate with left cervix and corresponding uterine horn. The right hemivagina was markedly distended (5.63 cm). Its lower end was convex and placed 4.75 cm above the introitus []. The upper end communicated with the right uterine horn, which was distended through the right cervix. Signal intensity of the contents of distended right hemi vagina and uterine horn appeared iso-intense on T1WI and hyperintense on T2WI [Figure and ], with thick mucoid collection (hemicolpos and hemimetra). The right kidney was not visualized and the left kidney was marginally enlarged [].