The Application Value Of Magnetic Resonance Imaging In The Diagnosis Of MRKH Syndrome:Comparison With Laparoscopic Surgery

Objectives: MRKH syndrome(Mayer-Rokitansky-Küster-Hauser syndrome)is a female reproductive system disease characterized by hypoplasia of the upper 2 / 3 of the uterus and vagina.It is often accompanied by abnormal changes in multiple systems such as urine and bone,which seriously affects women ’s physical and mental health.In recent years,with the development of medical imaging technology,MRI(magnetic resonance imaging)is considered to be the best imaging method for the diagnosis of MRHK syndrome because of its high soft tissue resolution and clear three-layer signal of uterus on T2 WI.It can also be used as a diagnostic basis for preoperative resection or preservation of functional uterus.The purpose of this study was to evaluate the accuracy of preoperative MRI in the diagnosis of MRKH syndrome and the possibility of optimizing the surgical plan.This study aimed to evaluate the accuracy of preoperative magnetic resonance imaging(MRI)in the diagnosis of Mayer Rokitansky-Küster-Hauser(MRKH)syndrome to optimize surgical planning.Methods: MRI images and surgical records of 60 patients with MRKH syndrome confirmed by surgery in Shenzhen Luohu District People ’s Hospital from August2015 to May 2022 were collected from the electronic medical record system.All The60 patients underwent laparoscopic surgery.MRI images were judged by an experienced radiologist on the development of uterus,ovary and vagina,and then checked by a senior physician.Laparoscopic findings are described in the surgical record.Chi-square Test and Kappa Consistency Test were used to calculate the consistency between MRI diagnosis and laparoscopic surgery.Results: MRI findings of 60 patients with MRKH syndrome were retrospectively analyzed.The mean age was 23 years.MRI showed bilateral primordial uterus in 55cases(91.67 %),unilateral primordial uterus in 4 cases(6.67%),no uterus in 1cases(1.66 %).There were 31 cases of MRKH type I and 29 cases of MRKH type II.All the 60 patients received laparoscopic assisted artificial vagina formation.Results There is no statistical difference between MRI diagnosis of uterine malformation,ovarian and vaginal atresia and laparoscopic finding(P value >0.05).Cohen’s kappa value of MRI diagnosis of uterine malformation and laparoscopy was 0.707,and the Cohen’s kappa value of vaginal atresia or incomplete atresia was 0.848,the Cohen’s kappa value of ovarian displayed was 0.868.Conclusions:Our results are consistent with previous studies.In patients with MRKH syndrome,MRI findings before surgery are highly consistent with those seen during laparoscopy.Because of its high soft tissue resolution,MRI can display the degree of malformation of uterus,ovarian and vagina in multiple directions and layers,and can also find the accompanying abnormal changes of kidney and bone at the same time.MRI can provide important information for the diagnosis and treatment of MRKH syndrome,and is a reliable method for auxiliary diagnosis and preoperative evaluation.