Imaging of Ambiguous Genitalia:
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EDUCATION EXHIBIT
1891
Imaging of Ambiguous Genitalia: Classification and Diagnostic Approach1
CME FEATURE
See accompanying test at http:// www.rsna.org /education /rg_cme.html
Govind B. Chavhan, MD, DNB • Dimitri A. Parra, MD • Kamaldine Oudjhane, MD • Stephen F. Miller, MD • Paul S. Babyn, MD • Joao L. Pippi Salle, MD Disorders of sex development (DSDs) are congenital conditions in which the development of chromosomal, gonadal, or anatomic sex is atypical. DSDs can be classified broadly into four categories on the basis of gonadal histologic features: female pseudohermaphroditism (46,XX with two ovaries); male pseudohermaphroditism (46,XY with two testes); true hermaphroditism (ovotesticular DSD) (both ovarian and testicular tissues); and gonadal dysgenesis, either mixed (a testis and a streak gonad) or pure (bilateral streak gonads). Imaging plays an important role in demonstrating the anatomy and associated anomalies. Ultrasonography is the primary modality for demonstrating internal organs; genitography is used to assess the urethra, vagina, and any fistulas or complex tracts; and magnetic resonance imaging is used as an adjunct modality to assess for internal gonads and genitalia. Early and appropriate gender assignment is necessary for healthy physical and psychologic development of children with ambiguous genitalia. Gender assignment can be facilitated with a team approach that involves a pediatric endocrinologist, geneticist, urologist, psychiatrist, social worker, neonatologist, nurse, and radiologist, allowing timely diagnosis and proper management.
©
LEARNING OBJECTIVES FOR TEST 3
After reading this article and taking the test, the reader will be able to:
■ List
broad categories of disorders of sex development that cause
EDUCATION EXHIBIT
1891
Imaging of Ambiguous Genitalia: Classification and Diagnostic Approach1
CME FEATURE
See accompanying test at http:// www.rsna.org /education /rg_cme.html
Govind B. Chavhan, MD, DNB • Dimitri A. Parra, MD • Kamaldine Oudjhane, MD • Stephen F. Miller, MD • Paul S. Babyn, MD • Joao L. Pippi Salle, MD Disorders of sex development (DSDs) are congenital conditions in which the development of chromosomal, gonadal, or anatomic sex is atypical. DSDs can be classified broadly into four categories on the basis of gonadal histologic features: female pseudohermaphroditism (46,XX with two ovaries); male pseudohermaphroditism (46,XY with two testes); true hermaphroditism (ovotesticular DSD) (both ovarian and testicular tissues); and gonadal dysgenesis, either mixed (a testis and a streak gonad) or pure (bilateral streak gonads). Imaging plays an important role in demonstrating the anatomy and associated anomalies. Ultrasonography is the primary modality for demonstrating internal organs; genitography is used to assess the urethra, vagina, and any fistulas or complex tracts; and magnetic resonance imaging is used as an adjunct modality to assess for internal gonads and genitalia. Early and appropriate gender assignment is necessary for healthy physical and psychologic development of children with ambiguous genitalia. Gender assignment can be facilitated with a team approach that involves a pediatric endocrinologist, geneticist, urologist, psychiatrist, social worker, neonatologist, nurse, and radiologist, allowing timely diagnosis and proper management.
©
LEARNING OBJECTIVES FOR TEST 3
After reading this article and taking the test, the reader will be able to:
■ List
broad categories of disorders of sex development that cause