Case of the Week: Septate Uterus (MRI)

In this radiology lecture, we discuss the MRI appearance of septate uterus, and explain how to differentiate from other uterine anomalies.

Key points include:

Most common müllerian duct anomaly (55%): Septal reabsorption abnormality.
Ultrasound and MRI provide assessment of external uterine contour and presence of renal anomalies.
Hysterosalpingogram of limited value, cannot reliably differentiate between subtypes.
On MRI, uterine fundus is typically convex or minimally indented: Fundal cleft less than 1 cm.
Midline septum of variable length, may be muscular or fibrous.
Important to differentiate type of septum as may alter surgical approach.
Compared to bicornuate uterus, higher incidence of reproductive complications (miscarriage).
Treatment: Resection of septum if recurrent fetal loss.

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