MR imaging of intersexuality

Intersexuality involves an intermingling of the characteristics of each sex in varying degrees as a result of some flaw in embryonic development. Accurate demonstration of genital anatomy is essential for proper gender assignment and for treatment of intersexual disorders. Genital anatomy is well demonstrated with MR imaging, which offers unsurpassed soft-tissue contrast, multiplanar capability, and no radiation exposure. Intersexual disorders can be categorized into female pseudohermaphroditism, male pseudohermaphroditism, gonadal dysgenesis or agenesis, and true hermaphroditism. In female pseudohermaphroditism, MR images show normal internal female genitalia with masculinized external genitalia. In male pseudohermaphroditism, MR images show normal or mildly defective testes with incompletely masculinized external genitalia. In gonadal dysgenesis, combinations of normal, dysgenetic, and streak gonads are seen on MR images; in gonadal agenesis, no gonads are evident. In true hermaphroditism, both testicular and ovarian tissue is seen on MR images. MR imaging is essential for management of intersexual disorders.