Aim The high incidence of congenital reproductive system abnormalities in girls strongly demands perfecting the methods for diagnosis of this pathology in paediatric gynaecology. Aim – to assess the informative value of magnetic resonance imaging in visualisation of various abnormalities of the vagina and the uterus in female adolescents.
Materials and methods The study was carried out on the basis of the MRI Department in collaboration with the Reproductive Health Department of the Research Centre for Children’s Health FSBI MHRF. A total of 30 girls aged from 8 to 14 years with suspected diagnosis of reproductive system abnormality have been examined. Apart from the ultrasound examination, all the patients underwent MRI of the pelvis. A 3.0 Tesla MRI scanner (Discovery 750, GE) and a 1.5 Tesla MRI scanner (Optima 450w, GE) were used. Standard pelvic MRI examination involved T1- and T2-weighted pulse sequences, the FatSat technique, the short-tau inversion recovery (STIR) sequence and diffusion weighted imaging (DWI) in three orthogonal planes (sagittal, coronal and axial). Obtained MRI data were checked against those obtained in laparoscopic procedures.
Results Vaginal atresia of various grades with the development of hematocolpos was detected in 30% of the examined patients; duplication of the uterus and vagina with partial vaginal atresia of various grades in 27% of patients; duplication of the uterus and vagina with the development of unilateral hematometrocolpos combined with ipsilateral renal hypoplasia in 20%; a bicornuate uterus with the development of hematosalpinx in 13%; a septate uterus with vaginal septa of various length in 10% of the patients. In 28 cases (94%), MRI data were in line with the laparoscopic results. The MRI patterns were found to be partly inaccurate in 2 cases only.
Conclusion Thus, the MRI of the pelvis is the most informative method to diagnose congenital reproductive system abnormalities. It enables evaluating the nature of the pathology, effects of therapy over time and efficacy of the performed surgical intervention.
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