PRIMARY AMENORRHEA - EVALUATION WITH MR-IMAGING

PURPOSE: To determine the accuracy of magnetic resonance (MR) imaging in the evaluation of patients with a history of primary amenorrhea. MA TERIALS AND METHODS: Twenty-nine patients with primary amenorrhea unde rwent T2-weighted MR imaging in the axial and sagittal planes. Contras t material-enhanced and unenhanced T1-weighted MR imaging was performe d in selected cases. MR imaging findings were correlated with surgical findings in 23 patients and with clinical findings in six patients. R ESULTS: Surgical correlation was available in 14 of 17 patients with f emale anatomic anomalies (Mayer-Rokitansky-Kuster-Hauser syndrome [n = 9], transverse vaginal septum [n = 3], imperforate hymen [n = 1], cer vical agenesis [n = 1]), which confirmed MR imaging findings. In nine of 12 patients with congenital disorders of sexual differentiation (te sticular feminization [n = 5], true hermaphrodite [n = 2], gonadal dys genesis [n = 2]) who underwent surgical correlation, 13 of 16 (81%) go nads were correctly localized with MR imaging. Overall, there was exce llent correlation between the classification of patients with MR imagi ng versus classification with the combination of surgical and laborato ry findings (kappa = 0.88). CONCLUSION: MR imaging is useful in the wo rk-up of patients who present with primary amenorrhea both for accurat e diagnosis of pathologic conditions and for surgical planning.