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The uterus, cervix and upper 2/3 vagina form from fusion and medial
wall resorption of paired Mullerian ducts. Approximately 15% of
uterine anomalies consist of unicornuate uterus which results from
normal development of one Mullerian duct with hypoplasia or aplasia
of other duct. The appearance of the Fallopian tube varies, and
ovarian development is usually normal. The spectrum of findings
are as follows:
- Simple unicornuate 35%: The entire uterus usually appears just
a bit smaller than normal uterus.
- Noncavitary rudimentary horn 33%: The horn can look like a mass.
- Noncommunicating cavitary horn 22%: (this case) There is a variable
level of endometrial differentiation in the horn and thus there
is a variable response to endogenous hormones.
- Communicating cavitary horn 10%: These cases must be differentiated
from patients with bicornuate uterus in whom asymmetry has developed
due to previous pregnancy.
Patient symptoms depend on anatomy. If obstruction at cervix or
vagina is present then hydrometra or hydrometrocolpos will develop.
A complication of cavitary noncommunicating horns is endometriosis.
Approximately 40% of patients have associated urinary tract anomalies:
ectopic kidney, agenesis, cystic dysplasia, duplicated coll system
(same side as rudimentary horn). Spontaneous abortion and premature
labor are more common.
Reference:
- Brody et al. AJR 1998:171:1341.
Location and Date of Scan: New York University Medical Center,
New York, Aug 2001
Scanner Model Used: Siemens Symphony with Quantum gradients
Coil Used: Torso phased-array coil
Software version: A11
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