Arcuate uterus
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An arcuate uterus is a mildly variant shape of the uterus. It is technically one of the Müllerian duct anomalies, but is often classified as a normal variant. It is the uterine anomaly that is least commonlyassociated with reproductive failure. Arcuate uterus can be characterised with ultrasound or MRI.
Pathology
An arcuate uterus is characterised by a mild indentation of the endometrium at the uterine fundus. It occurs due to a failure of complete resorption of the uterovaginal septum, and is the most common Mullerian duct anomaly, affecting 3.9% of the general population 7.
Radiographic features
General features include:
- normal fundal contour
- no division of uterine horns
- smooth indentation of fundal endometrial canal: the depth of indentation is usually considered to be <1 cm
- increased transverse diameter of uterine cavity
Fluoroscopy
On hysterosalpingograms there is opacification of the endometrial cavity demonstrates a single uterine canal with a broad saddle-shaped indentation of the uterine fundus.
Pelvic ultrasound
A normal external uterine contour is noted, with a broad smooth indentation on the fundal segment of the endometrium. There should not be division of the uterine horns.
MRI
A normal external uterine contour is maintained. The myometrial fundal indentation is smooth and broad, and the signal intensity of this region is isointense to normal myometrium.
Differential diagnosis
-
septate uterus
- arcuate uterus and septate uterus exist on a spectrum from least to most resorption of the uterovaginal septum, respectively
-
bicornuate uterus
- arcuate uterus can be distinguished from a bicornuate uterus on the basis of its complete fundal unification (i.e. an arcuate uterus has a normal or slightly indented external fundal contour, whereas a bicornuate uterus has a more marked fundal indentation, ≤5 mm above the level of the uterine horns)
-<p>An<strong> arcuate uterus</strong> is a mildly variant shape of the uterus. It is technically one of the <a href="/articles/mullerian-duct-anomalies">Müllerian duct anomalies</a>, but is often classified as a normal variant. It is the uterine anomaly that is least commonly<strong> </strong>associated with reproductive failure. Arcuate uterus can be characterised with ultrasound or MRI.</p><h4>Pathology</h4><p>An arcuate uterus is characterised by a mild indentation of the endometrium at the uterine fundus. It occurs due to a failure of complete resorption of the uterovaginal septum, and is the most common Mullerian duct anomaly, affecting 3.9% of the general population <sup>7</sup>.</p><h4>Radiographic features</h4><p>General features include:</p><ul>- +<p>An<strong> arcuate uterus</strong> is a mildly variant shape of the <a title="uterus" href="/articles/uterus">uterus</a>. It is technically one of the <a href="/articles/mullerian-duct-anomalies">Müllerian duct anomalies</a>, but is often classified as a normal variant. It is the uterine anomaly that is least commonly<strong> </strong>associated with reproductive failure. Arcuate uterus can be characterised with ultrasound or MRI.</p><h4>Pathology</h4><p>An arcuate uterus is characterised by a mild indentation of the <a title="endometrium" href="/articles/endometrium">endometrium</a> at the uterine fundus. It occurs due to a failure of complete resorption of the <a title="uterovaginal septum" href="/articles/uterovaginal-septum">uterovaginal septum</a>, and is the most common <a title="Mullerian duct anomaly" href="/articles/mullerian-duct-anomalies">Mullerian duct anomaly</a>, affecting 3.9% of the general population <sup>7</sup>.</p><h4>Radiographic features</h4><p>General features include:</p><ul>
-</ul><h5>Fluoroscopy</h5><p>On <a href="/articles/hysterosalpingogram">hysterosalpingograms</a> there is opacification of the endometrial cavity demonstrates a single uterine canal with a broad saddle-shaped indentation of the uterine fundus.</p><h5>Pelvic ultrasound</h5><p>A normal external uterine contour is noted, with a broad smooth indentation on the fundal segment of the endometrium. There should not be division of the uterine horns.</p><h5>MRI</h5><p>A normal external uterine contour is maintained. The myometrial fundal indentation is smooth and broad, and the signal intensity of this region is isointense to normal myometrium.</p><h4>Differential diagnosis</h4><ul>- +</ul><h5>Fluoroscopy</h5><p>On <a href="/articles/hysterosalpingogram">hysterosalpingograms</a> there is opacification of the endometrial cavity demonstrates a single uterine canal with a broad saddle-shaped indentation of the uterine fundus.</p><h5>Pelvic ultrasound</h5><p>A normal external uterine contour is noted, with a broad smooth indentation on the fundal segment of the <a title="endometrium" href="/articles/endometrium">endometrium</a>. There should not be division of the uterine horns.</p><h5>MRI</h5><p>A normal external uterine contour is maintained. The myometrial fundal indentation is smooth and broad, and the signal intensity of this region is isointense to normal <a title="myometrium" href="/articles/myometrium">myometrium</a>.</p><h4>Differential diagnosis</h4><ul>
-<a href="/articles/septate-uterus">septate uterus</a><ul><li>arcuate uterus and septate uterus exist on a spectrum from least to most resorption of the uterovaginal septum, respectively</li></ul>- +<a href="/articles/septate-uterus">septate uterus</a><ul><li>arcuate uterus and <a title="septate uterus" href="/articles/septate-uterus">septate uterus</a> exist on a spectrum from least to most resorption of the uterovaginal septum, respectively</li></ul>
-<a href="/articles/bicornuate-uterus">bicornuate uterus</a><ul><li>arcuate uterus can be distinguished from a <a href="/articles/bicornuate-uterus">bicornuate uterus</a> on the basis of its complete fundal unification (i.e. an arcuate uterus has a normal or slightly indented external fundal contour, whereas a bicornuate uterus has a more marked fundal indentation, ≤5 mm above the level of the uterine horns)</li></ul>- +<a href="/articles/bicornuate-uterus">bicornuate uterus</a><ul><li>arcuate uterus can be distinguished from a <a href="/articles/bicornuate-uterus">bicornuate uterus</a> on the basis of its complete fundal unification (i.e. an arcuate uterus has a normal or slightly indented external fundal contour, whereas a <a title="bicornuate uterus" href="/articles/bicornuate-uterus">bicornuate uterus</a> has a more marked fundal indentation, ≤5 mm above the level of the uterine horns)</li></ul>
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