EURORAD ESR

Case 14563

The clinical relevance of anatomical variants!

Author(s)
Romeu Duarte Mesquita1, Marta Sousa1, Filipa Vilaverde1, Daniela Pinto2, José Leão Rosas1

(1) Hospital de São Sebastião,
Centro Hospitalar de Entre o Douro e Vouga,
Radiologia, Portugal;
(2) Hospital São João,
Centro Hospitalar São João,
Radiologia, Portugal
Email:romeu.mesquita@gmail.com
 
Patient
female, 13 year(s)
 
 
  • Figure 1
    Ultrasound

    Sagittal transabdominal US image shows an elliptical echogenic mass, which represents the vaginal cavity markedly distended with blood products (haematocolpos). The uterus extends from the superior aspect of the mass.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 2
    Ultrasound

    Transverse transabdominal US image shows uterus didelphys, with two uterine horns and two separated endometrial cavities.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 3
    Sagittal fast spin-echo T2-WI

    MR image shows a dilated hemivagina whose content has signal characteristics of blood, forming a blind-ending pouch secondary to obstruction.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 4
    Axial fast spin-echo T1-WI

    A large haematocolpos centrally (arrow), a finding that corresponds to the obstructed right hemivagina. Mild dilatation of the right endometrial cavity and a nondistended left endometrial cavity are also seen.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 5
    Coronal T2-WI

    Coronal T2-weighted image of a uterus didelphys, obtained in plane with the uterus, shows two widely divergent uterine horns (arrows) separated by a deep fundal cleft.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 6
    Coronal FSE T2-WI

    Coronal fast spin-echo T2-WI shows a solitary left kidney, confirming renal agenesis with bowel loops in the right renal fossa, which is ipsilateral to the obstructed hemivagina.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 7
    MR T2-WI

    Transverse oblique T2-WI obtained with fat suppression demonstrate communication of the right uterine horn (curved arrow) with the dilated left hemivagina (arrow); the appearance of the left uterine horn is normal.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 8
    Axial T1-WI of the pelvic floor

    The distal third of the two hemivaginas (arrows) separated by a band of fibrous tissue (arrowhead); the obstructed right hemivagina is already dilated, containing heterogeneous debris, which indicates distal obstruction.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
Sagittal transabdominal US image shows an elliptical echogenic mass, which represents the vaginal cavity markedly distended with blood products (haematocolpos). The uterus extends from the superior aspect of the mass.
 
Transverse transabdominal US image shows uterus didelphys, with two uterine horns and two separated endometrial cavities.
 
MR image shows a dilated hemivagina whose content has signal characteristics of blood, forming a blind-ending pouch secondary to obstruction.
 
A large haematocolpos centrally (arrow), a finding that corresponds to the obstructed right hemivagina. Mild dilatation of the right endometrial cavity and a nondistended left endometrial cavity are also seen.
 
Coronal T2-weighted image of a uterus didelphys, obtained in plane with the uterus, shows two widely divergent uterine horns (arrows) separated by a deep fundal cleft.
 
Coronal fast spin-echo T2-WI shows a solitary left kidney, confirming renal agenesis with bowel loops in the right renal fossa, which is ipsilateral to the obstructed hemivagina.
 
Transverse oblique T2-WI obtained with fat suppression demonstrate communication of the right uterine horn (curved arrow) with the dilated left hemivagina (arrow); the appearance of the left uterine horn is normal.
 
The distal third of the two hemivaginas (arrows) separated by a band of fibrous tissue (arrowhead); the obstructed right hemivagina is already dilated, containing heterogeneous debris, which indicates distal obstruction.
 
 
 
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