Learning objectives
To use clay models as a visual aid and teaching tool for normal reproductive and urinary embrology,
and their associated congenital disorders
To understand the clinical significance of mullerian duct abnormalities
To correlate case based MR imaging of mullerian duct abnormalities with clay model representations
Background
The complex anatomy and specific terminology within embryology make this subject difficult to teach.
Furthermore,
the developmental abnormalities of the urogenital system become prohibitively complex on imaging if the fundamental structural pathways are not fully understood.
Clay models are a cost effective and intuitive teaching tool for embryological development because it allows for accurate three dimensional representation of anatomy.
Additionally,
the tactile experience of creating these models serves to solidify anatomical knowledge.
The clay is easily altered to demonstrate subtle changes of each embryological component...
Findings and procedure details
Agenesis and Hypoplastic MDAs
Mayer-Rokitansky-Kuster-Hauser syndrome represents the most extreme end of this cluster of MDAs with complete agenesis of the proximal vagina,
cervix,
and uterus.
This presents as primary amenorrhea.
(Fig.
6) demonstrates a case of a 17 year old female with a history of amenorrhea who underwent an MRI that demonstrated upper vaginal agensis and cervical hypogensis (arrows),
and a small rudimentary uterus.
Large simple cyst (arrowhead) in the midline is a cystic bulge at the confluence of the converging midline fallopian tubes....
Conclusion
It is important to understand the foundation of urogenital embryology in order to accurately recognize development abnormalities encountered on imaging.
Clay models serve as highly effective teaching method,
especially with regards to the ability to alter normal anatomy in real time to reflect the various mullerian developmental abnormalities.
References
1.
Gönül Öçal.
Current Concepts in Disorders of Sexual Development. J Clin Res Pediatr Endocrinol.
2011; Sep; 3(3): 105–114.
2.Spencer C.
Behr,
MD,
Jesse L.
Courtier,
MD,
Aliya Qayyum,
MBBS.
Imaging of Müllerian Duct Anomalies. RadioGraphics 2012; 32:E233–E250.
3.
Beatriz L.
P.
Junqueira,
MD,
Lisa M.
Allen,
MD,
FRCSC,
Rachel F.
Spitzer,
MD,
BSc,
MPH,
FRCSC,
Kerith L.
Lucco,
MD,
Paul S.
Babyn,
MD,
CM,
Andrea S.
Doria,
MD,
PhD,
MSc.Müllerian Duct Anomalies and Mimics in Children and Adolescents: Correlative Intra-operative Assessment with Clinical Imaging....