Septate uterus

From RadsWiki

Jump to: navigation, search


[edit] Discussion of Septate uterus

  • Septate uterus is the most common müllerian duct anomaly (composes approximately 55% of müllerian duct anomalies)
  • Results from partial or complete failure of resorption of the uterovaginal septum after fusion of the paramesonephric ducts.
  • The septate uterus is also associated with the worst obstetric outcome of the müllerian duct anomalies.
  • Reproductive outcome has been shown to improve after resection of the septum, with reported decreases in the spontaneous abortion rate from 88% to 5.9% after hysteroscopic metroplasty.

  • The septum, which arises in the midline fundus, is considered to be complete when it extends to the external cervical os.
  • The external uterine contour may be convex, flat, or mildly (<1.0-cm) concave.
  • The configuration of the external uterine contour is crucial for the differentiation of a septate from a bicornuate uterus, because widely different clinical and interventional approaches are assigned to each anomaly.
    • A septate uterus is often treated with hysteroscopic resection of the septum.
    • Bicornuate uteri rarely necessitate surgical intervention.

[edit] Imaging Findings for Septate uterus

[edit] HSG

  • Accuracy of alone is only 55% for differentiation of septate from bicornuate uteri.
  • An angle of less than 75° between the uterine horns is suggestive of a septate uterus, and an angle of more than 105° is more consistent with bicornuate uteri.
  • Unfortunately, the majority of angles of divergence between the horns fall within this range, and considerable overlap between the two anomalies is noted.

[edit] US

  • At US, the echogenic endometrial cavities are separated at the fundus by the intermediate echogenicity of the myometrium in all partial septa and within the fundal segments of complete septa.
  • The external uterine contour must demonstrate a convex, flat, or mildly concave configuration and may best be appreciated on transverse images of the uterus.

[edit] MRI

  • On MR images, the septate uterus is generally normal in size and each endometrial cavity appears smaller than the configuration of a normal cavity.
  • In both partial and complete septa, the signal intensity within the fundal segment of the septum is isointense with the adjacent myometrium.

[edit] Images

Patient #1

File:Smlaxi1.JPG==See Also== File:Smlaxi2.JPG==

[edit] External Links

[edit] References for Septate uterus