title: Comparison of different diagnostic procedures for the staging of malformations associated with Mayer-Rokitansky-Küster-Hauser syndrome.
abstract: OBJECTIVE
  To compare different diagnostic procedures for staging malformations associated with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.
  
  
  METHODS
  Retrospective two-center cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred and thirty-eight women with MRKH.
  
  
  METHODS
  Clinical examinations, abdominal or perineal/rectal ultrasound, magnetic resonance imaging (MRI), and laparoscopy.
  
  
  METHODS
  Agreement between the results obtained with the other methods and the results obtained with the reference methods for correct staging of malformations, presented as kappa values (κ).
  
  
  RESULTS
  The VCUAM (vagina cervix uterus adnex-associated malformation) classification system was used to classify genital malformations in 138 women with MRKH. The reference methods for examining the individual organs were: vagina-clinical examination; cervix/uterus and adnexa-laparoscopy; and urinary tract malformations-MRI. The values obtained were as follows. Vagina was κ 0.74 for MRI versus clinical examination; ultrasound and laparoscopy did not allow adequate description of vaginal malformations. Cervical findings were rarely detailed with any of the imaging methods. Uterus was κ 0.93 for MRI versus laparoscopy, and κ 0.83 for ultrasound. For adnexa, only laparoscopy was able to describe the morphology adequately. The urinary tract was κ 0.87 for ultrasound versus MRI.
  
  
  CONCLUSIONS
  For the correct staging of malformations associated with MRKH, MRI or a combination of clinical examination and ultrasound are equivalent. However, none of the imaging methods adequately describes adnexal morphology.
authors.affiliation: Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Lermann
authors.forename: Andreas
authors.initials: A
authors.lastname: Mueller
authors.forename: Erika
authors.initials: E
authors.lastname: Wiesinger
authors.forename: Lothar
authors.initials: L
authors.lastname: Häberle
authors.forename: Sara
authors.initials: S
authors.lastname: Brucker
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.forename: Ralf
authors.initials: R
authors.lastname: Dittrich
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Renner
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: Patricia G
authors.initials: PG
authors.lastname: Oppelt
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging; D000015:Abnormalities, Multiple / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging; D000290:Adnexa Uteri / Q000002:abnormalities / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000002:abnormalities / Q000000981:diagnostic imaging; D015331:Cohort Studies; D000013:Congenital Abnormalities; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities; D009095:Mullerian Ducts / Q000002:abnormalities; D012189:Retrospective Studies; D019170:Somites / Q000002:abnormalities; D013131:Spine / Q000002:abnormalities; D014463:Ultrasonography; D014599:Uterus / Q000002:abnormalities / Q000000981:diagnostic imaging; D014621:Vagina / Q000002:abnormalities / Q000000981:diagnostic imaging; D055815:Young Adult