Application of magnetic resonance imaging and ultrasound in diagnosis of disorder of sexual development

Objective To investigate the application of magnetic resonance imaging (MRI) and ultrasound in the diagnosis of disorder of sexual development, and to compare the imaging results with the surgical and pathological results to improve the diagnosis of disorder of sexual development. Methods This present retrospective cases series included 43 patients who were diagnosed disorder of sexual development in the First Affiliated Hospital of Zhengzhou University from April 2007 to September 2018. There were 17 patients undergoing laparoscopic gonad exploration or resection, analysis their MRI, ultrasound and surgical pathology results. Results For these 17 patients with disorder of sexual development, 30 glands were found during surgery. Among all these 30 glands, 22 were detected by MRI with an accuracy rate of 76.4%, 16 were detected by MRI with an accuracy rate of 58.8%, and 24 were detected by the combination of MRI and ultrasound with an accuracy rate of 82.3%. The accuracy rate of glands in MRI combined ultrasound group was significantly higher than that in ultrasound group (P=0.031). Between MRI combined ultrasound group and MRI group, there was no significant difference in the accuracy rate of detective glands (P>0.05). In 17 patients with disorder of sexual development, 12 cases of uterus were observed in surgical, 13 cases were diagnosed by MRI, 1 case was over-diagnosed; 11 cases were observed in ultrasound, and 1 case was missed. The correct rate of MRI/ultrasound diagnosis for uterus was 94%. Conclusion MRI and ultrasound have high accuracy for the diagnosis of gonad and uterus dysplasia. Ultrasound is superior to MRI in detecting pelvic ovarian tissue. The MRI is better at showing the testicular tissue in the pelvic and inguinal than ultrasound, both of the MRI and ultrasound show could clear ovarian tissue and uterus in patients with disorder of sexual development; the combination with these two methods can improve the accuracy of gonad and uterus diagnosis. Key words: Magnetic resonance imaging; Hermaphroditism; Ultrasound; Disorder of development