AMBIGUOUS GENITALIA - COMPARATIVE ROLE OF PELVIC ULTRASONOGRAPHY AND GENITOGRAPHY

Ambiguous genitalia represents a true medical and social emergency whi ch needs a multi-disciplinary team approach for elucidation. The paedi atric radiologist plays an important role in defining the genital anat omy which remains one of the most important factors in sex determinati on. Aiming to compare the predictive value of pelvic ultrasonography a nd genitography in sex determination in patients with ambiguous genita lia, we retrospectively reviewed the medical records of 69 patients, 5 3 females and 16 males, where both procedures were employed. In female pseudohermaphroditism, the presence of a uterus with or without vagin a was predicted in 46 (86.8%) patients by ultrasound compared with 44 (83%) patients in whom a genitogram revealed a vagina +/- uterus. In s ix (11.3%) patients, a genitogram revealed a male-type urethra. The co mbination of ultrasound and genitogram, however, was more sensitive an d predicted the presence of a uterus with or without vagina in 52 (98. 1%) patients. In male pseudo-hermaphroditism, there was no false posit ive by ultrasound, and a genitogram revealed a male-type urethra in 12 (75%) patients. In conclusion, although real time pelvic ultrasonogra phy is less invasive than genitography, its yield in elucidating genit al anatomy is comparable. The combination of both procedures is more i nformative and has a better yield.