Uterus didelphys

The diagnosis of the didelphys uterus can also be made by ultrasound. However, the sonographic diagnosis is facilitated by the clinical knowledge of double cervices. On ultrasound, in the transverse planar section, the two uterine bodies with echogenic endometrial focus are well demonstrated. Demonstration of the extent of the septum into the vagina by ultrasound, however, may be more difficult. MRI is rarely requested in the diagnosis of didelphys uterus. However, when MRI is performed, two separate normal size uteri and cervices are seen with a septum extending into the upper vagina (Fig.1).The uterine horns are usually widely separated, and the endometrial and myometrial widths are preserved. Rarely, separate haematouteri with completely separated vaginas, including two vaginal orifices can be seen. The use of MRI in uterus didelphys is utilized more in the evaluation of its complications. A common complication is uterine obstruction caused by oblique or transverse position of one of the vaginal septa. In these cases, the blood-dilated uterine cavity and the cervical canal, and the superior vagina are well demonstrated on MRI, which also provides a characterization of the intrauterine fluid, blood. In the case of uterine obstruction, the coexisting pathology is often endometrioma. When infection occurs, the extent of the infection from the uterus to the periuterine tissue is also best appreciated on magnetic resonance. The diagnosis of uterine didelphys can also be made by CT, especially when complications occur, and the uterine cavities are distended. However, due to the presence of radiation, CT is not considered a preferred modality. If sonographic findings (in the case of complications) are equivocal, MRI should be the procedure of choice.

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