MULTIMODAL RADIOLOGICAL DIAGNOSIS OF UTEROVAGINAL MULLERIAN DUCT ANOMALIES; A THREE-YEAR EXPERIENCE IN TERTIARY CARE HOSPITAL, PESHAWAR

Nasreen Aman; Muhammad Imran Khan; Fatima Sultan Ahmad; Shehzadi Saima Hussain; Fariha Afzal; Laila Khan

doi:10.46903/gjms/24.1.2120

MULTIMODAL RADIOLOGICAL DIAGNOSIS OF UTEROVAGINAL MULLERIAN DUCT ANOMALIES; A THREE-YEAR EXPERIENCE IN TERTIARY CARE HOSPITAL, PESHAWAR

Nasreen Aman, Muhammad Imran Khan, Fatima Sultan Ahmad, Shehzadi Saima Hussain, Fariha Afzal, Laila Khan

Abstract

Background: Müllerian duct anomalies (MDAs) are congenital uterovaginal malformations with significant reproductive and gynecological implications. Early and accurate diagnosis is essential for effective management. This study aimed to determine the frequency and spectrum of uterovaginal Müllerian duct anomalies in a tertiary care hospital and to assess the role of multimodal imaging using the ASRM MAC 2021 classification

Materials & Methods: This retrospective cross-sectional study was conducted at the Radiology Department of Lady Reading Hospital, Peshawar, using HMIS data from January 2022 to December 2024. Patients aged ≥12 years with radiologically confirmed uterovaginal anomalies were included (n=150). Ultrasound and pelvic MRI were used for evaluation, and anomalies were classified according to the ASRM Müllerian Anomaly Classification (MAC) 2021. Data were analyzed using SPSS v26. Descriptive statistics were reported; an independent-samples t-test compared uterine bud dimensions between infantile and prepubertal uterus. A total of 150 patients aged ≥12 years with radiologically confirmed uterovaginal anomalies were included. Imaging modalities used were ultrasound & MRI. Anomalies were classified per ASRM MAC 2021 criteria.

Results: Mean age was significantly lower in patients presenting with primary amenorrhea (16.8±4.07 years) compared with other presentations (27.22±9.58 years; p<0.01). The most frequent anomaly was dysplastic/infantile uterus (34.4%), followed by bicornuate uterus (24.0%) and transverse vaginal septum (13.9%). Ultrasound was the primary imaging modality (124/150), while MRI was used for problem-solving (26/150). Craniocaudal uterine bud length differed significantly between infantile and prepubertal uterus (p=0.007).

Conclusion: Uterovaginal MDAs constitute a substantial diagnostic workload in tertiary care. A structured multimodal imaging approach guided by ASRM MAC 2021 improves characterization and communication with gynecology teams, supporting appropriate clinical management.

Keywords

Mullerian duct abnormalities; Uterine anomalies; Uterine duplication anomalies; Vaginal septum.

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DOI: https://doi.org/10.46903/gjms/24.1.2120