Arcuate uterus
Last revised by Mohammadtaghi Niknejad ◉ on 30 Nov 2022
Citation, DOI & article data
Citation:
Yang N, Niknejad M, El-Feky M, et al. Arcuate uterus. Reference article, Radiopaedia.org (Accessed on 04 Feb 2023) https://doi.org/10.53347/rID-6974
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rID:
6974
Article created:
31 Aug 2009 by Natalie Yang ◈
Revisions:
45 times by 17 users - see full revision history
Systems:
Synonyms:
- Arcuate Womb
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 commonly associated with reproductive failure. Arcuate uterus can be characterized with ultrasound or MRI.
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Pathology
An arcuate uterus is characterized 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.
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Differential diagnosis
-
septate uterus
- arcuate uterus and septate uterus exist on a spectrum from most to least 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)
- fundal fibroid: on hysterosalpingography can exert smooth indentation of fundal endometrium giving similar appearance to arcuate uterus 8
Quiz questions
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References
- 1. Ubeda B, Paraira M, Alert E et-al. Hysterosalpingography: spectrum of normal variants and nonpathologic findings. AJR Am J Roentgenol. 2001;177 (1): 131-5. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Chaudhry S. AJR Teaching File: infertility in a young woman. AJR Am J Roentgenol. 2007;189 (3): S11-2. doi:10.2214/AJR.07.7019 - Pubmed citation
- 3. Dykes, Thomas M.; Siegel, Cary; Dodson, William. American Journal of Roentgenology. doi:10.2214/AJR.06.0821
- 4. Troiano RN, Mccarthy SM. Mullerian duct anomalies: imaging and clinical issues. Radiology. 2004;233 (1): 19-34. doi:10.1148/radiol.2331020777 - Pubmed citation
- 5. Imaoka I, Wada A, Matsuo M et-al. MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Radiographics. 23 (6): 1401-21. doi:10.1148/rg.236025115 - Pubmed citation
- 6. Mucowski SJ, Herndon CN, Rosen MP. The arcuate uterine anomaly: a critical appraisal of its diagnostic and clinical relevance. Obstet Gynecol Surv. 2010;65 (7): 449-54. doi:10.1097/OGX.0b013e3181efb0db - Pubmed citation
- 7. Behr SC, Courtier JL, Qayyum A. Imaging of müllerian duct anomalies. Radiographics. 2012;32 (6): E233-50. doi:10.1148/rg.326125515 - Pubmed citation
- 8. Panchal S & Nagori C. Chapter-03 Abnormal Uterus. A Complete Textbook for GNM Internship. 2015;:41-76. doi:10.5005/jp/books/12608_4
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