Using 3D MRI can potentially enhance the ability of trained surgeons to more precisely diagnose Mullerian duct anomalies compared to MR alone

Objective: The aim of this study was to examine if the advanced tool of 3D MRI model provides more precise information on the anatomy of pelvic organs than MRI alone, and compare to clinical and operative finding of patients with vagina in Müllerian duct anomalies.

Study design: One hundred and ten patients with clinically and operatively proven Müllerian duct anomalies were included. The consistency of diagnosis of Mullerian tract anomalies by MRI and 3D MRI compared to clinically and surgically proven anomalies defined according to ASRM classification.

Results: We successfully reconstructed retrospectively all 110 patients' three-dimensional models from the simple MRI scans. Eighty-six of the patients (78.2%) showed an agenesis of the uterus, four patients presented with uterine didephys (3.6%). Septate uterus was detectable in 8 of 110 cases (7.3%). Arcuate uterus was detectable in 3 of 110 cases (2.7%). The remaining patients presented with either unilateral (n = 4; 3.6%) or bilateral (n = 5; 4.5%) uterine horns. Reviewed by radiologists, comparing the agreement rate between 3D- MRI reconstruction models and simple MRI, there was a trend towards but not significant difference (P = 0.064). Reviewed by trained surgeons, the agreement between three-dimensional MRI reconstruction models and MRI, there was significant difference (P = 0.003).

Conclusion: 3D MRI model is a non-expensive add-on software tool that enhance the ability of expert surgeon to reach a more precise diagnosis of the pelvic anatomy structures, compared to MRI alone. Getting a more precise description of the pelvic anatomy allows a better planning of the corrective procedure needed and preoperative assessment of the expected prognosis.