DETECTION OF URETHRAL DIVERTICULA IN WOMEN - COMPARISON OF A HIGH-RESOLUTION FAST SPIN-ECHO TECHNIQUE WITH DOUBLE-BALLOON URETHROGRAPHY

Purpose: We compared a rapid high resolution magnetic resonance imagin g (MRI) technique to contrast urethrography for the detection of ureth ral diverticula in women. Materials and Methods: During a 19-month int erval 13 patients with clinically suspected urethral diverticula were evaluated with MRI and contrast urethrography. All patients were refer red by a urologist, and had clinical signs and symptoms suggesting the presence of a urethral diverticulum. Double balloon urethrography was performed in 12 patients and voiding cystourethrography was done in 1 . MRI was performed using a fast spin echo T2-weighted pulse sequence and a dedicated pelvic multicoil. Following a sagittal localizer seque nce 3 mm. thick axial sections were obtained from the bladder base thr ough the entire urethra. Total imaging time was 15 minutes. Results: I n 7 patients MRI and urethrography were negative for urethral divertic ula, and in 3 cystourethroscopy was negative. In 1 patient MRI reveale d a vaginal inclusion cyst confirmed by surgery. Three patients had no other studies or procedures performed. In 6 patients MRI was positive for urethral diverticula, including 4 in whom the diverticulum was co nfirmed at surgery, 1 who declined surgery and 1 who was lost to follo wup. Of the 4 patients (75%) with a surgically confirmed diverticulum double balloon urethrogram was negative in 3. Conclusions: MRI is a va luable noninvasive technique for determining the presence of urethral diverticula as well as detecting other abnormalities. In our study MRI had a higher sensitivity for detecting diverticula and a much higher negative predictive rate.