Presentation
Vaginal bleeding.
Patient Data
Two separated, divergent uterine horns (angle = 95°) with a fundal cleft (>2 cm). The endometrial cavities as well as the cervices are uniformly separate in keeping with a uterus didelphys.
Thickening of the endometrial-myometrial junctional zone up to 20 mm of both uterine horns mainly on the left eliciting an intermediate signal on T1, low signal intensity on T2 with foci of high signal within, indicating menstrual hemorrhage into the ectopic endometrial tissues in keeping with diffuse adenomyosis.
A small right unilocular ovarian cyst (32 mm) is noted.
Case Discussion
MRI features of uterine adenomyosis in a uterus didelphys.
Uterus didelphys is a type of Müllerian duct anomaly (class III) where there is a complete duplication of uterine horns as well as duplication of the cervix, with no communication between them. It accounts for approximately ~8% of Müllerian duct anomalies.
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