Magnetic resonance imaging and ultrasound in the assessment of female patients presenting with noncentral causes of primary amenorrhea

Background Noncentral primary amenorrhea is concerned with Müllerian duct agenesis, other Müllerian duct anomalies with obstruction, and gonadal dysgenesis. Aim To detect the value of ultrasound (US) and MRI in diagnosing and following patients with noncentral causes of primary amenorrhea. Patients and methods A prospective study was carried out on 50 females aged between 12 and 25 years old in the childbearing period presenting with primary amenorrhea complaining of cyclic lower abdominal pain and abdominal swelling and female patients whose US examination revealed obstructive outflow tract and uterine anomalies. All patients were subjected to US and MRI examinations. Results MRI has an accuracy of 100% in the assessment of Müllerian duct anomalies, especially demonstrating the absence or hypoplasia of the uterus, while the US has an accuracy of 96%. MRI has an accuracy of 100% in evaluating associated ovarian anomalies, especially ovarian agenesis, whereas the US has an accuracy of 94%. US and MRI are involved in assessing obstructed Müllerian anomalies and their secondary effects with an accuracy of 100%. The final diagnosis of the cases was obstructive Müllerian anomalies as the commonest cause (25/50 cases, 50%), followed by Müllerian agenesis (20/50 cases, 40%) and gonadal dysgenesis (5/50 cases, 10%). Conclusion US and MRI are both efficient and accurate in the assessment of cases with noncentral primary amenorrhea.