Decoding Müllerian Duct Anomalies with MRI: Implementing the New ASRM Classification SystemDecoding Müllerian Duct Anomalies with MRI: Implementing the New ASRM Classification System

Objective: To explore and categorize various Müllerian duct anomalies using magnetic resonance imaging (MRI) and evaluate these findings within the frameworks of the updated American Society for Reproductive Medicine (ASRM) system.  Methods: A retrospective analysis of pelvic MRI scans with Müllerian anomalies between July 2023 and December 2024.  Subjects: This study reviewed the pelvic MRI scans and medical records of 19 female patients diagnosed with congenital Müllerian anomalies between July 2023 and December 2024. The patients’ ages ranged from 2 to 63 years, with a mean age of 22 years.  Results: A wide spectrum of Müllerian anomalies was observed in the study population, with the distribution of 3 patients (15.7%) Müllerian hypoplasia/ agenesis (type I), 5 patients (26.3%) bicornuate anomaly (type IV), 7 patients (36.8%) septate uterus (type V) and 3 patients (15.7%) arcuate uterus (type VI). No patients were identified to have didelphus, unicornuate or DES drug related anomalies Figure 1,2)  Conclusion: MRI proved to be an invaluable tool for accurately identifying and characterizing Müllerian anomalies, regardless of their complexity. The ASRM system, with its simplified and visually descriptive approach, was particularly advantageous in the radiological setting, providing clarity and streamlining the classification process.