Twenty-nine patients underwent magnetic resonance (MR) imaging for investigation of müllerian duct anomalies (MDAs). The anomalies evaluated were uterine agenesis (n = 2), uterine hypoplasia (n = 5), unicornuate uterus (n = 5), uterus didelphys (n = 5), bicornuate uterus (n = 10), and septate uterus (n = 2). The MR imaging interpretation was correlated with results of laparotomy (n = 18), hysterosalpingography (HSG) (n = 5), laparoscopy (n = 2), hysteroscopy (n = 1), HSG and laparotomy (n = 2), and HSG and laparoscopy (n = 1). MR imaging enabled correct classification of the anomaly in each patient and identification of coincidental gynecologic disease in 10 patients (34%). MR imaging results influenced clinical treatment in six (24%) of 25 patients referred prospectively. Of particular value was the ability to characterize septal tissue (myometrium versus fibrous tissue), identify the patients in whom the septum of bicornuate uteri had both fibrous and myometrial components, and establish that suspected adnexal lesions were actually components of obstructed MDAs.
