MRI Features and Diagnostic Challenges in Abdominal Pregnancy and its Mimickers: A Case Series

Authors

  • Ardhin Martdana Department of Radiology, Dr. Soetomo General Academic Hospital, Surabaya, Jawa Timur, Indonesia /Faculty of Medicine, Universitas Airlangga, Surabaya, Jawa Timur, Indonesia
  • Lies Mardiyana Department of Radiology, Dr. Soetomo General Academic Hospital, Surabaya, Jawa Timur, Indonesia /Faculty of Medicine, Universitas Airlangga, Surabaya, Jawa Timur, Indonesia

DOI:

https://doi.org/10.3941/jrcr.6085

Abstract

This study aims to present a case series of abdominal pregnancies and their mimickers, emphasizing the role of Magnetic Resonance Imaging (MRI) in diagnosis and management. The primary method used was evaluation with MRI for superior anatomical visualization. MRI successfully differentiated between an intrauterine pregnancy in a didelphic uterus (Case 1) and true abdominal pregnancies (Cases 2, 3, and 4). Key MRI features of abdominal pregnancy include: a thin-walled gestational sac, a placenta with irregular borders and heterogeneous texture, and vascularization originating from branches of the abdominal aorta. In conclusion, MRI is an invaluable imaging modality for diagnosing and assessing abdominal pregnancies. Diagnostic accuracy is enhanced by a systematic approach that includes careful anatomical assessment (aided by vaginal distension using hydrogel when necessary), analysis of placental and gestational sac wall characteristics, and evaluation of vascularization.

Magnetic resonance imaging (MRI) 3 Tesla, T2-weighted sequences (T2WI). The image shows the uterus located on the right side. The fetus appears superior to the uterus, suggesting an extrauterine position. The vagina and cervix are difficult to evaluate Mullerian anomaly. (a) Coronal view (b) Axial view (c) Sagital view.

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Published

2026-07-30

Issue

Vol. 20 No. 7 (2026)

Section

Obstetric & Gynecologic Radiology

License

Copyright (c) 2026 Journal of Radiology Case Reports

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