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Objective@#To explore the role of MRI in the pre-operative diagnosis and classification of oblique vaginal septum syndrome (OVSS) .@*Methods@#A retrospective analysis of the clinical records and pre-operative MRI images of 19 patients with surgery proved OVSS was carried out. Two experienced radiologists reviewed the pre-operative pelvic MRI of the 19 patients in consensus blind to the surgery results. Characteristics including malformations of the uterus, cervix and vagina, the diagnosis of the disorder and classification were evaluated. Pre-operative MRI diagnosis and classification were correlated with surgical findings.@*Results@#Mean age of onset of symptoms for the 19 patients was 15 years (ranged 9-25 years) , and mean age of menarche was 12 years. Ten patients suffered from dysmenorrhea or lower abdominal pain, 5 patients complained of vaginal discharge, 3 patients had a history of irregular menstruation, 1 patient suffered from primary infertility. All 19 patients showed uteri didelphys. Eighteen patients showed vaginal oblique septum.One patient showed cervical atresia.MRI was completely correlated with the surgery in the pre-operative diagnosis of OVSS. MRI classification was in line with surgery in 17 patients, including 9 patients with imperforate septum (typeⅠ) , 6 patients with perforate septum (type Ⅱ) , 1 patient with imperforate septum and cervical fistula (type Ⅲ) , and another one with cervical agenesis (type Ⅳ) . One case of type Ⅱ was misdiagnosed as type Ⅰ, another one of type Ⅰ was misdiagnosed as type Ⅲ. Pre-operative MRI classification was correlated with surgery in 17 out of 19 patients.@*Conclusion@#Pre-operative MRI allows excellent manifestation and accurate diagnosis of OVSS, and could also facilitate the evaluation of the classification.
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Objective To investigate the clinical value of MRI in the diagnosis of oblique vaginal septum syndrome(OVSS),and to improve the diagnostic level for this disease.Methods Clinical and imaging data of 8 patients (7 adolescent females and 1 female in fertility period)with vaginal septum syndrome were analyzed retrospectively.All participants were evaluated by ultrasound examination before MRI scanning,and 1 of them underwent enhanced MRI scan.Results Among the 8 patients with OVSS,the main findings of MRI includes uterine deformity (4 double uterus,3 mediastinal uterus,1 double angle uterus with uterine septum),oblique vaginal septum (7 right oblique septum and 1 left oblique septum).All subjects presented with ipsilateral renal agenesis,and 4 patients with endometriosis,1 patient with ureteral distortion and ectopic opening and 1 patient with double inferior vena cava.6 patients suffered with hemorrhage in the posterior chamber of oblique septum and 2 patients with empyema.Hemorrhage in the contralateral vagina were observed in 3 cases,while no significant abnormality was found in other 5 cases.Conclusion MRI scan has an important clinical value on the diagnosis of OVSS and can provide crucial information for the optimal individual treatment.
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Objective To investigate the imaging findings of oblique vaginal septum syndrome and its diagnostic value.Methods Clinical and radiographic data of 13 patients with oblique vaginal septum syndrome were analyzed retrospectively and relevant literatures were reviewed.All 13 patients underwent ultrasonography examination preoperatively,and 8 of them underwent MRI examination,and 3 patients underwent CT examination as well.The position of the oblique septum,the size of the cavity in the rear of oblique septum, the positional relationship between the cavity in the rear of oblique septum and the cervix,and the concomitant changes of the uterine appendages and urinary system were analyzed.Results The ultrasonography and MRI examinations all manifested as uterus didelphys,cervix duplex,double vagina and obstructed hemivagina,and oblique septum originated from the middle of cervix duplex and attached to one side of the vaginal wall,shielding the ipsilateral cervix;oblique vaginal septum was on the right side in 4 cases and on the left side in 9 cases;the average volume of the cavity in the rear of oblique septum in 6 cases of type Ⅰ was 255 mL,and the average volume in 6 cases of type Ⅱ was 74 mL,and the volume in 1 case of type Ⅲ was 56 mL;2 cases were combined with ipsilateral hematosalpinx and 1 case was combined with a chocolate cyst of ipsilateral ovary;12 cases were accompanied with ipsilateral renal agenesis and 1 case was accompanied with ipsilateral renal hypoplasia.CT examinations of 3 cases all presented as uterus didelphys,a cystic hypodensity lesion under unilateral cervix and ipsilateral renal agenesis.Conclusion Imaging findings of oblique vaginal septum syndrome are quite characteristic. Ultrasonography,CT and MRI examinations have certain value for accurate diagnosis of the disease.
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Objective To investigate the imaging findings of oblique vaginal septum syndrome and its diagnostic value.Methods Clinical and radiographic data of 13 patients with oblique vaginal septum syndrome were analyzed retrospectively and relevant literatures were reviewed.All 13 patients underwent ultrasonography examination preoperatively,and 8 of them underwent MRI examination,and 3 patients underwent CT examination as well.The position of the oblique septum,the size of the cavity in the rear of oblique septum, the positional relationship between the cavity in the rear of oblique septum and the cervix,and the concomitant changes of the uterine appendages and urinary system were analyzed.Results The ultrasonography and MRI examinations all manifested as uterus didelphys,cervix duplex,double vagina and obstructed hemivagina,and oblique septum originated from the middle of cervix duplex and attached to one side of the vaginal wall,shielding the ipsilateral cervix;oblique vaginal septum was on the right side in 4 cases and on the left side in 9 cases;the average volume of the cavity in the rear of oblique septum in 6 cases of type Ⅰ was 255 mL,and the average volume in 6 cases of type Ⅱ was 74 mL,and the volume in 1 case of type Ⅲ was 56 mL;2 cases were combined with ipsilateral hematosalpinx and 1 case was combined with a chocolate cyst of ipsilateral ovary;12 cases were accompanied with ipsilateral renal agenesis and 1 case was accompanied with ipsilateral renal hypoplasia.CT examinations of 3 cases all presented as uterus didelphys,a cystic hypodensity lesion under unilateral cervix and ipsilateral renal agenesis.Conclusion Imaging findings of oblique vaginal septum syndrome are quite characteristic. Ultrasonography,CT and MRI examinations have certain value for accurate diagnosis of the disease.
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Objective To assess the application of MRI in diagnosis of oblique vaginal septum syndrome (OVSS).Methods Clinical and imaging data of 41 patients with OVSS confirmed by surgery from March 2011 to November 2016 were retrospectively analyzed.Results The average age of patients was 20.5 year (10-46 years).The primary clinical symptoms were menorrhalgia (16 cases) and menorrhagia (13 cases).There were 12 cases of type Ⅰ,23 cases of type Ⅱ,5 cases of type Ⅲ and 1 case of type Ⅳamong 41 cases of OVSS.The resections for OVSS were performed in 35 cases.Forty two cases were diagnosed as OVSS by MRI scan,and 41 were confirmed by surgery,the accuracy of MRI diagnosis was 97.6％ (41/42).MRI showed uterus didelphys,hydrocolpos or hematocolpos with varying degrees,and revealed ipsilateral renal agenesis in all 41 cases.Conclusion MRI scan can accurately diagnose oblique vaginal septum syndrome and provide comprehensive information for clinical treatment.
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Objective To explore the efficacy of hysteroscopy combined with laparoscopy in the diagnosis and treatment of Herlyn-Werner-Wunderlich syndrome (HWWS).Methods The clinical data of 23 patients with HWWS from January 2009 to December 2015 treated with combination of laparoscopy and hysteroscopy were retrospectively analyzed.The patients had different degrees of dysmenorrhea (17 cases),abnormal vaginal discharge (17 cases),and infertility (4 cases) before surgery.During followup,we observed the symptom and pregnancy outcomes after surgery.Results The patients were followed up for 3-36 months (average,24 months).The vaginal irregular bleeding and abnormal secretions disappeared in 17 patients;dysmenorrhea relieved partly in 17 cases;4 patients who had fertility requirements gave birth to babies.Conclusion Combination of hysteroscopy and laparoscopy sufficiently clears genital malformation of HWWS and solves the lower genital tract obstruction.