title: Correlation between MRI and double-balloon urethrography findings in the diagnosis of female periurethral lesions.
abstract: This study aims to evaluate the correlation of MRI findings with double-balloon urethrography (DBU) in diagnosing female urethral diverticula and other periurethral lesions. In this retrospective study, females with clinically suspected periurethral lesions who underwent both MRI and DBU between 2008 and 2012 were evaluated. MRI was performed on a 1.5 Tesla unit using a pelvic phased array coil. Protocol included small FOV pelvic images, multiplanar T2-w, T1-w with and without contrast injection. DBU was performed by a dedicated catheter. Images were evaluated in consensus by two readers. Diverticula were evaluated by, size, number, complexity, location and connection to urethra, and other periurethral lesions were evaluated by size, location and connection. Supplement clinical and surgical data were retrieved from medical records and telephone interviews. Seventeen females (mean age 44 years, range 20-69) were included in the study. Diverticula were diagnosed by both modalities (9 cases), by neither (6 cases, 88% correlation) by MRI alone (1 case) and by DBU alone (1 case). Among diverticula, correlation of number, complexity, location and demonstration of connection to urethra was 89%, 67%, 67%, and 56%, respectively. Alternative diagnosis solely by MRI included vaginal wall cysts (3 cases), endometriosis (1 case) and ectopic ureter (1 case). No periurethral lesion was found by either modality in 2 cases. The correlation between MRI and DBU in diagnosing female periurethral lesions is very good for anatomical delineation of diverticula. MRI, which does not involve radiation, may also indicate alternative diagnoses that can contribute to proper patient management.
authors.affiliation: Department of Diagnostic Imaging, Sheba Medical Center, Tel Hasomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: Orith.Portnoy@sheba.health.gov.il.
authors.forename: Orith
authors.initials: O
authors.lastname: Portnoy
authors.forename: Noam
authors.initials: N
authors.lastname: Kitrey
authors.forename: Iris
authors.initials: I
authors.lastname: Eshed
authors.forename: Sara
authors.initials: S
authors.lastname: Apter
authors.forename: Marianne M
authors.initials: MM
authors.lastname: Amitai
authors.forename: Jacob
authors.initials: J
authors.lastname: Golomb
mesh_terms: D000328:Adult; D000368:Aged; D002406:Catheterization, Peripheral / Q000379:methods*; D004240:Diverticulum / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014521:Urethra / Q000000981:diagnostic imaging* / Q000473:pathology*; D014522:Urethral Diseases / Q000175:diagnosis*
keywords: Diverticulum; Double balloon urethrography; MRI; Urethra