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Table 2 Hww syndrome: mr findings

From: Herlyn-werner-wunderlich syndrome: MRI findings, radiological guide (two cases and literature review), and differential diagnosis

HWW SYNDROME MR FINDINGS
Uterus didelphys It is characterized by two symmetric, widely divergent uterine horns and two cervixes, with an enlarged cavity filled by bloody/proteinaceous fluid due to haematocolpos. It appears hyperintense signal on T1 fat saturated sequences.
Hemivagina It is an obstructed vagina due to a longitudinal septum which occludes one cervix and isolates it with consequent hematometra.
Renal aplasya It is tipically omolateral to the vaginal anomaly (right side prevalence), with possible controlateral renal hypertrophy due to compensation but in site.
Ovaries Possible presence of endometriosic cysts with hyperintense signal on T1 fat sat sequences and with "shading sign" on T2-weighted images and a gradual variation of signal intensity due to chronic bleeding with accumulation of high concentration of iron and protein in the endometrioma (endometriotic lesions appear hyperintense on T1-weighted images and mildly hypointense or hyperintense on T2-weighted images). Possible presence of functional cysts with no clinical significance, which appear hyperintense on T2 sequences and hypo/isointense on T1 sequences.