Arcuate uterus
Updates to Article Attributes
An arcuate uterus is a mildly variant shape of the uterus. It is technically one of the Müllerian duct anomalies, but is often classified as a normal variant. It is the uterine anomaly that is least commonlyassociated with reproductive failure. Arcuate uterus can be characterised with ultrasound or MRI.
Pathology
An arcuate uterus is characterised by a mild indentation of the endometrium at the uterine fundus. It occurs due to a failure of complete resorption of the uterovaginal septum, and is the most common Mullerian duct anomaly, affecting 3.9% of the general population 7.
Radiographic features
General features include:
- normal fundal contour
- no division of uterine horns
- smooth indentation of fundal endometrial canal: the depth of indentation is usually considered to be <1 cm
- increased transverse diameter of uterine cavity
Fluoroscopy
On hysterosalpingograms there is opacification of the endometrial cavity demonstrates a single uterine canal with a broad saddle-shaped indentation of the uterine fundus.
Pelvic ultrasound
A normal external uterine contour is noted, with a broad smooth indentation on the fundal segment of the endometrium. NoThere should not be division of the uterine horns.
MRI
A normal external uterine contour is maintained. The myometrial fundal indentation is smooth and broad, and the signal intensity of this region is isointense to normal myometrium.
Differential diagnosis
-
septate uterus
- arcuate uterus and septate uterus exist on a spectrum from least to most resorption of the uterovaginal septum, respectively
-
bicornuate uterus
- arcuate uterus can be distinguished from a bicornuate uterus on the basis of its complete fundal unification (i.e.
thean arcuate uterus has a normal or slightly indented external fundal contour, whereasthea bicornuate uterus has a more marked fundal indentation,no more than 5≤5 mm above the level of the uterine horns)
- arcuate uterus can be distinguished from a bicornuate uterus on the basis of its complete fundal unification (i.e.
-</ul><h5>Fluoroscopy</h5><p>On <a title="Hysterosalpingogram" href="/articles/hysterosalpingogram">hysterosalpingograms</a> there is opacification of the endometrial cavity demonstrates a single uterine canal with a broad saddle-shaped indentation of the uterine fundus.</p><h5>Pelvic ultrasound</h5><p>A normal external uterine contour is noted, with a broad smooth indentation on the fundal segment of the endometrium. No division of the uterine horns.</p><h5>MRI</h5><p>A normal external uterine contour is maintained. The myometrial fundal indentation is smooth and broad, and the signal intensity of this region is isointense to normal myometrium.</p><h4>Differential diagnosis</h4><ul>- +</ul><h5>Fluoroscopy</h5><p>On <a href="/articles/hysterosalpingogram">hysterosalpingograms</a> there is opacification of the endometrial cavity demonstrates a single uterine canal with a broad saddle-shaped indentation of the uterine fundus.</p><h5>Pelvic ultrasound</h5><p>A normal external uterine contour is noted, with a broad smooth indentation on the fundal segment of the endometrium. There should not be division of the uterine horns.</p><h5>MRI</h5><p>A normal external uterine contour is maintained. The myometrial fundal indentation is smooth and broad, and the signal intensity of this region is isointense to normal myometrium.</p><h4>Differential diagnosis</h4><ul>
-<a href="/articles/bicornuate-uterus">bicornuate uterus</a><ul><li>arcuate uterus can be distinguished from a <a href="/articles/bicornuate-uterus">bicornuate uterus</a> on the basis of its complete fundal unification (i.e. the arcuate uterus has a normal or slightly indented external fundal contour, whereas the bicornuate has a more marked fundal indentation, no more than 5 mm above the level of the uterine horns)</li></ul>- +<a href="/articles/bicornuate-uterus">bicornuate uterus</a><ul><li>arcuate uterus can be distinguished from a <a href="/articles/bicornuate-uterus">bicornuate uterus</a> on the basis of its complete fundal unification (i.e. an arcuate uterus has a normal or slightly indented external fundal contour, whereas a bicornuate uterus has a more marked fundal indentation, ≤5 mm above the level of the uterine horns)</li></ul>
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