Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Wangfujing Street, Dongcheng District, Beijing, 100730, People's Republic of China.
Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Wangfujing Street, Dongcheng District, Bejing, 100730, People's Republic of China.
Eur Radiol. 2017 Dec;27(12):5215-5224. doi: 10.1007/s00330-017-4919-4. Epub 2017 Jul 3.
To characterize the anatomical features and clinical settings of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and correlate them with patterns of uterine involvement.
Pelvic magnetic resonance images and medical records of 92 MRKH patients were retrospectively reviewed. Patients were subgrouped by uterine morphology: uterine agenesis, unilateral rudimentary uterus and bilateral rudimentary uteri. Uterine volume, presence of endometrium, location of ovary, endometriosis and pelvic pain were compared among groups.
The mean uterine volume was 33.5 ml (17.5-90.0 ml) for unilateral uterine remnants, and 16.1 ml (3.5-21.5 ml) for bilateral uterine rudiments (p<0.01). The incidence of presence of endometrium (100% vs. 22%, p<0.001), haematometra (56% vs. 3%, p<0.001) and ovarian endometriosis (22% vs. 3%, p<0.01) was significantly increased in the group of unilateral rudimentary uteri as compared with the group of bilateral uterine remnants. Thirty-one patients (38%) showed ectopic ovaries. Pelvic pain was more common in individuals with unilateral rudimentary uterus than those who had no (56% vs. 5%, p<0.01) or bilateral uterine remnants (56% vs. 14%, p<0.05).
MRKH patients with different patterns of uterine involvement may have differentiated anatomical features and clinical settings.
• Rudimentary uteri, especially bilateral rudimentary uteri, were quite common in MRKH syndrome. • Uterine remnants can be relatively large, especially the unilateral rudimentary uterus. • Presence of endometrium and related complications are not rare in MRKH syndrome. • Existence of endometrium and complications are more frequent in unilateral rudimentary uterus.
描述 Mayer-Rokitansky-Küster-Hauser（MRKH）综合征的解剖学特征和临床特征，并将其与子宫受累模式相关联。
回顾性分析 92 例 MRKH 患者的盆腔磁共振图像和病历。根据子宫形态将患者分为子宫发育不全组、单侧残角子宫组和双侧残角子宫组。比较各组间子宫体积、子宫内膜存在情况、卵巢位置、子宫内膜异位症和盆腔疼痛。
单侧残角子宫组的平均子宫体积为 33.5ml（17.5-90.0ml），双侧残角子宫组为 16.1ml（3.5-21.5ml）（p<0.01）。单侧残角子宫组子宫内膜存在率（100% vs. 22%，p<0.001）、宫腔积血（56% vs. 3%，p<0.001）和卵巢子宫内膜异位症（22% vs. 3%，p<0.01）的发生率明显高于双侧残角子宫组。31 例（38%）患者存在卵巢异位。单侧残角子宫患者的盆腔疼痛发生率高于无子宫残留组（56% vs. 5%，p<0.01）和双侧残角子宫组（56% vs. 14%，p<0.05）。
不同子宫受累模式的 MRKH 患者可能具有不同的解剖学特征和临床特征。
残角子宫，特别是双侧残角子宫，在 MRKH 综合征中很常见。
子宫残留可能相对较大，尤其是单侧残角子宫。
子宫内膜的存在及其相关并发症在 MRKH 综合征中并不罕见。
单侧残角子宫中存在子宫内膜和并发症更为常见。
