Introduction: MRKH syndrome represents total or partial agenesis of the uterus and the two-thirds portion of the vagina, with 46XX karyotyping and normal bilateral ovaries and a Fallopian tube. Despite the uterus agenesis, the Mullerian remnants, including uterine buds, fibrous bands, and midline triangular soft tissue, are visible. Magnetic Resonance Imaging (MRI) is a non-invasive modality with 100% accuracy, which is ideal for depicting Mullerian duct anomalies. Materials and Methods: This is a descriptive study using a retrospective approach done in Dr. Soetomo General Hospital Surabaya and has obtained ethical permission. Our samples included 38 data from pelvic MRI acquired from medical records in Dr. Soetomo General Hospital between May 2018 and January 2022. Results: The age group between 21 and 30 constituted a significant proportion of MRKH patients. The location of the right and left uterine buds relative to the ovarium were identified repeatedly in the anterior caudal, appearing isointense in the T2WI sequence. The right fibrous band was evident in 35 patients (94.7%), while the left fibrous band appeared in 35 patients (92.1%). Midline triangular soft tissue was visible in 35 patients (92.1%), showing a hypointense signal, 35 patients (92.1%) with intrapelvic right and left ovaries, and one patient (2.6%) with left endometrioma. The proximal vagina was not apparent in all patients, while 31 patients (81.6%) were shown to have the distal vagina. Conclusion: MRI can yield accurate information in describing anatomical abnormalities in MRKH. Although the findings of this study have been satisfactory, further research entailing larger samples is necessary to correlate the MRI features and surgery outcomes to assess its reliability.

uterine buds

fibrous bands

MRKH

MRI

Mullerian