Diagnostic efficacy of ultrasound-MRI multimodality for MRKH syndrome

苏志虹 黄枢 陈丽旋 杨鸣 姜雨燕 李琪虹

doi:10.16098/j.issn.0529-1356.2026.01.009

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Acta Anatomica Sinica ›› 2026, Vol. 57 ›› Issue (1) : 58-63. DOI: 10.16098/j.issn.0529-1356.2026.01.009

Robotics and Surgical Navigation Column

Diagnostic efficacy of ultrasound-MRI multimodality for MRKH syndrome

SU Zhi-hong¹, HUANG Shu¹, CHEN Li-xuan¹, YANG Ming¹, JIANG Yu-yan², LI Qi-hong^1*

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Abstract

Objective To investigate the diagnostic efficacy of ultrasound and magnetic resonance imaging (MRI) in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, while exploring the potential applications of artificial intelligence (AI) in disease diagnosis and surgical planning. MethodsA retrospective analysis was conducted on 28 patients diagnosed with MRKH syndrome via ultrasound and MRI at 73rd Group Army hospital of the People’s Liberation Army of China from July 2018 to May 2025. Clinical and imaging data were collected, with surgical confirmation as the gold standard. Imaging characteristics of MRKH syndrome on ultrasound and MRI were analyzed, and detection rates between modalities were compared. ResultsThe result showed that all 28 cases of MRKH had no vagina. Among them, 26 cases presented with a spindle-shaped primordial uterus on both sides of the pelvis. Only one case had a uterine cavity shadow in both primordial uteri as shown by MRI, while the remaining 25 cases had no endometrium or cervix. The lower margins of the primordial uteri on both sides were connected by a cord-like band behind the bladder. Two cases presented with only one primordial uterus in the pelvis, without endometrium or cervix. One case had a unilateral primordial uterus combined with a huge myoma, and both primordial uteri were still visible after surgery. The ovaries were in normal positions in both sides in all 28 cases of MRKH, and one ovary was combined with a teratoma. The cord-like band showed uniform echo in 27 cases and a worm-like echo in one case, with rich blood flow and varicose vein-like appearance. In abdominal or transrectal ultrasound examination, 46 primordial uteri were detected, with 8 missed, and the detection rate was 85.2%. In MRI examination, 49 primordial uteri were detected, with 5 missed, and the detection rate was 90.7%. In the combined ultrasound and MRI examination, 53 primordial uteri were detected, with 1 missed, and the detection rate was 98.1%. There was no significant difference in the detection rate of MRKH between ultrasound and MRI (P>0.05), while the detection rate and diagnostic accuracy of MRKH syndrome by the combined ultrasound and MRI were significantly higher than those by single ultrasound examination (P<0.05). ConclusionBoth ultrasound and MRI exhibit high sensitivity for MRKH syndrome, yet their combined use provides superior diagnostic value through multi-dimensional visualization of anatomical anomalies, offering critical guidance for clinical management.

Key words

MRKH syndrome / Ultrasound / Magnetic resonance imaging / Retrospective analysis / Female

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SU Zhi-hong, HUANG Shu, CHEN Li-xuan, YANG Ming, JIANG Yu-yan, LI Qi-hong. Diagnostic efficacy of ultrasound-MRI multimodality for MRKH syndrome[J]. Acta Anatomica Sinica. 2026, 57(1): 58-63 https://doi.org/10.16098/j.issn.0529-1356.2026.01.009

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