MR Imaging of Asherman's Syndrome in Patients With and Without Uterine Anomalies: Comparison withHysterosalpingography

PURPOSE: To assess the role of MR imaging in the detection of Asherman's syndrome, especially whenthis is associated with a congenital uterine anomaly. MATERIALS AND METHODS: MR images were obtained in thesemicoronal plane parallel to the long axis of the uterus in 11 patients. Dilatation and curettage involving thein-sertion of an intrauterine device was performed in all patients, and transabdominal metroplasty was performedin four with uterine anomaly. MR imaging findings we r e compared with those of hyste rosalpingograhy in all patients and compared with sur-gical findings in four. RESULTS: The MR findings of uterine synechiademonstrated in nine of 11 patients were focal thickening of the uterine junctional zone (n=2), hypointense fociin the en-dometrium (n=1), or both these findings (n=6). Seven of the 11 patients had associat-ed uterineanomalies, which were demonstrated in all seven by MR imaging. In four of the seven, HSG failed to demonstratethese anomalies. CONCLUSION: MR imaging satisfactorily demonstrated intrauterine lesions in nine of 11 patientswith Asherman's syndrome, and was especially helpful in demonstrating associated uterine anomalies.

Intrauterine Filling Defects on Hysterosalpingography Correlation with Hysteroscopic Findings

PURPOSE: To describe various hysterosalpingographic (HSG) findings of intrauterine lesions, and to determinethe correlation of these with their hysteroscopic findings. MATERIALS AND METHODS: This study involved 100patients who during a 23-month period underwent both HSG and hysteroscopic examinations. The HSG findings werecategorized as intrauterine adhesion, endometrial polyp, myoma, or 'other', and were correlated with hysteroscopicfindings and histologic diagnoses. RESULTS: Diagnoses based on HSG findings were intrauterine adhesions (n=80),endometrial polyps (n=8), myomas (n=10) and 'other' (n=2). The hysteroscopic diagnoses of these patients wereintrauterine adhesions (n=68), endometrial polyps (n=11), myomas (n=4), and 'other' (n=17). HSG and hysteroscopicdiagnoses were consistent 72 patients (72%). CONCLUSION: Lesions presenting as filling defects on HSG sometimesshow nonspecific or overlapping findings and the normal uterus may produce defects of this kind which mimicklesions.