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Purpose of Review <p>Female genital tract congenital anomalies (FGTCA) are a significant cause of infertility, recurrent pregnancy loss, pelvic pain, and obstetric complications. Accurate diagnosis and classification are essential for optimizing patient management and surgical planning. This review aims to provide a comprehensive overview of the imaging modalities used in the evaluation of FGTCAs, with a focus on the diagnostic strengths, limitations, and complementary roles of transabdominal, transvaginal, and 3D ultrasound, hysterosalpingography (HSG), and magnetic resonance imaging (MRI).</p> Recent Findings <p>Three-dimensional ultrasound has shown diagnostic performance comparable to MRI in differentiating septate from bicornuate and didelphys uterus, offering a cost-effective, first-line tool for triaging patients. HSG remains the standard for assessing tubal patency. MRI continues to be the gold standard due to its superior soft tissue contrast, multiplanar capabilities, and high-resolution, multiplanar assessment of uterine, cervical, and vaginal anatomy, as well as associated visceral anomalies, thus informing both surgical and clinical management.</p> Summary <p>A stepwise approach using ultrasound and HSG as initial modalities, followed by MRI for complex or inconclusive cases, provides a cost-effective and efficient diagnosis. Understanding the complementary strengths of these modalities optimizes diagnostic accuracy and individualizes patient care, ultimately improving and guiding clinical management.</p>

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Imaging Update for Diagnosis and Treatment Planning for Female Genital Tract Congenital Anomalies: What Does MR add?

  • 期刊论文

  • 发表日期：

    2025年12月29日

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  • Mary Costello,
  • Swati V. Putcha,
  • Jake Maxfield,
  • Myra K. Feldman

摘要

Purpose of Review

Female genital tract congenital anomalies (FGTCA) are a significant cause of infertility, recurrent pregnancy loss, pelvic pain, and obstetric complications. Accurate diagnosis and classification are essential for optimizing patient management and surgical planning. This review aims to provide a comprehensive overview of the imaging modalities used in the evaluation of FGTCAs, with a focus on the diagnostic strengths, limitations, and complementary roles of transabdominal, transvaginal, and 3D ultrasound, hysterosalpingography (HSG), and magnetic resonance imaging (MRI).

Recent Findings

Three-dimensional ultrasound has shown diagnostic performance comparable to MRI in differentiating septate from bicornuate and didelphys uterus, offering a cost-effective, first-line tool for triaging patients. HSG remains the standard for assessing tubal patency. MRI continues to be the gold standard due to its superior soft tissue contrast, multiplanar capabilities, and high-resolution, multiplanar assessment of uterine, cervical, and vaginal anatomy, as well as associated visceral anomalies, thus informing both surgical and clinical management.

Summary

A stepwise approach using ultrasound and HSG as initial modalities, followed by MRI for complex or inconclusive cases, provides a cost-effective and efficient diagnosis. Understanding the complementary strengths of these modalities optimizes diagnostic accuracy and individualizes patient care, ultimately improving and guiding clinical management.