Presentation
History of recent first trimester abortion.
Patient Data
MRI images of pelvis show normal sized, anteverted uterus with two symmetrical-sized uterine cavities, separated by a T2-weighted hypointense septum. The septum is seen in entire length of uterine cavity, extending from fundus to cervix. The external contour of uterine fundus is flat. These features are consistent with complete septate uterus.
Vaginal cavity appears normal.
STIR and T2 hyperintense polypoidal lesion is noted in right lower endometrial cavity with hypointense rim measuring 1.2 x 0.9 x 1.0 cm - likely representing endometrial polyp.
Small T2 hypointense intramural fibroid is noted in anterior wall of upper uterine segment- best seen on coronal image.
Both ovaries are normal.
Case Discussion
There are number of congenital uterine anomalies (Mullerian duct anomalies) with varying clinical presentations.
Hysterosalpingogram (HSG) can help in identification of unicornuate and bicornuate uterus.
Ultrasonography with 3-D reconstructions and MRI can help in differentiating septate and bicornuate uterus.
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