Magnetic Resonance Imaging (MRI) in Primary Amenorrhea: A Comprehensive Analysis

Objective: This study aims to investigate the frequency and underlying causes of primary amenorrhea utilizing MRI as a diagnostic tool. Material and Methods: Cross sectional prospective study was conducted at Department of Radiology, Liaquat National Hospital, Karachi for 1.5 years. However, sample size was limited due to very low prevalence. The uterus was examined in terms of normal growth and developmental abnormalities, such as rudimentary uterus, agenesis and hypoplasia. The ovaries were evaluated in terms of normal development, location anomalies, agenesis, presence of ovotestis and hypoplasia. Patients with ovarian tissue showing normal, hypoplastic, unilateral agenesis or location anomalies were examined for Müllerian duct anomalies. The cause of primary amenorrhea was detected using pelvic MRI as per operational definition. Results: In our study, a total of 14 patients were included who presented with complaints of primary amenorrhea. Out of these, 5 were diagnosed on mri as gonadal dysgenesis and 7 were diagnosed with mullerian duct abnormalities. While 2 were diagnosed with male pseudohermaphroditism and imperforate hymen. Among those who were diagnosed with gonadal dysgenesis, about 4 had sawyer syndrome while about 1 had ovarian hypoplasia. Among patients who had mullerian duct abonrmalities, about 5 had Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome which was the overall most common anomaly observed in our study. Conclusion: In conclusion, MRI is a useful modality that aids in early diagnosis of primary amenorrhea which helps in early intervention and surgical correction requiring multidisciplinary approach so as to aid in puberty, fertility and psychological care of the patient.