MRI features and differential diagnoses of congenital vaginal atresia

Abstract

Objective: To investigate the MRI manifestations of congenital vaginal atresia, analyze its imaging features, and improve the understanding of the disease.

Methods: MRI findings and clinical data of 12 patients with congenital vaginal atresia confirmed by hysteroscopy and laparoscopic surgery were retrospectively analyzed. Vaginal atresia was classified according to vaginal dysplasia in AFS female genital malformation classification system.

Results: In this study, 12 cases of congenital vaginal atresia were diagnosed by combined preoperative MRI with operative diagnosis. Among them, 10 patients all had type-I congenital vaginal atresia, and their uterus and cervix were normal (1 patient had ectopic renal malformation combined with left ovarian endometriosis cyst and 1 patient with uterine empyema). The other two cases were diagnosed congenital vaginal atresia type II (1 case merged with residual uterus, 1 case with cervical dysplasia). MRI mainly manifested as dilatation and hemorrhage in the uterine cavity, cervical canal and vaginal upper segment. T1WI showed high signal, T2WI showed slightly lower and slightly higher signal. The dilated vagina was above the perineal level.

Conclusion: MRI features of congenital vaginal atresia have certain characteristics. MRI cannot only accurately assess the type of vaginal dysplasia and its associated complications, but also make objective evaluation and diagnosis, so it can be used as the best effective preoperative image evaluation.

Chinese abstract

目的：探讨先天性阴道闭锁的MRI表现, 分析其影像学特点, 提高对该病的认识。

方法：回顾性分析12例经宫腔镜及腹腔镜手术证实的先天性阴道闭锁患者的MRI特点及临床数据资料。根据AFS女性生殖器畸形分类系统中阴道发育不良分类方法对阴道闭锁进行分类。

结果：本研究中, 12例先天性阴道闭锁患者术前经过MRI检查与手术诊断相结合给予确诊。其中10例为I型先天性阴道闭锁, 子宫、宫颈发育正常（1例为异位肾畸形合并左卵巢子宫内膜异位囊肿, 1例为子宫积脓）。其余2例诊断为先天性阴道闭锁II型（1例合并残角子宫, 1例宫颈发育不良）。MRI主要表现为宫腔、宫颈管及阴道上段扩张出血。T1WI显示出高信号, T2WI显示为低信号和高信号。阴道扩张位于会阴水平以上。

结论：先天性阴道闭锁的MRI表现具有一定的特点。MRI不仅能准确评价阴道发育不良的类型及其相关并发症, 而且能做出客观的评价和诊断, 可作为术前最佳的影像学评价手段。

Keywords:

• Congenital atresia
• vagina
• classification
• MRI
• differential diagnosis

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by Lanzhou science and technology planning project, Gansu, China (project number: 2018-3-29) and Lanzhou science and technology planning project, Gansu, China (project number: 2018-3-53).