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This review provides an overview of normal anatomy and imaging appearance of the vulva, including the mons pubis, labia majora, labia minora, clitoris, clitoral hood, external urethral meatus, vestibule and vaginal introitus, the Bartholin (greater vestibular) glands and the Skene (lesser vestibular or paraurethral) glands. We will also review the imaging appearance of various benign and malignant pathologies that affect these structures, including congenital adrenal hyperplasia, vulvar cancers, benign cysts, and urethral diverticula, with an emphasis on MR imaging. This discussion will be organized by anatomic structures to promote a thorough understanding of the pathologies which may occur in each anatomic subregion region and facilitate future referencing.<\/jats:p>","DOI":"10.1007\/s00261-025-05179-1","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T09:08:58Z","timestamp":1757408938000},"page":"2106-2124","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Under the hood: vulvar anatomy and pathology with a focus on MRI"],"prefix":"10.1007","volume":"51","author":[{"given":"Edwarda","family":"Golden","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan","family":"Cooke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Butler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Gregg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Gomez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"issue":"4","key":"5179_CR1","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1097\/01.ju.0000173639.38898.cd","volume":"174","author":"HE O\u2019Connell","year":"2005","unstructured":"H. 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