Correlation between MRI and double-balloon urethrography findingsin the diagnosis of female periurethral lesions

This study aims to evaluate the correlation of MRI findings with double-balloon urethrography (DBU) indiagnosing female urethral diverticula and other periurethral lesions.In this retrospective study, females with clinically suspected periurethral lesions who underwent bothMRI and DBU between 2008 and 2012 were evaluated. MRI was performed on a 1.5 Tesla unit using a pelvicphased array coil. Protocol included small FOV pelvic images, multiplanar T2-w, T1-w with and withoutcontrast injection. DBU was performed by a dedicated catheter. Images were evaluated in consensus bytwo 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 andsurgical data were retrieved from medical records and telephone interviews.Seventeen females (mean age 44 years, range 20?69) were included in the study. Diverticula werediagnosed by both modalities (9 cases), by neither (6 cases, 88% correlation) by MRI alone (1 case) and byDBU alone (1 case). Among diverticula, correlation of number, complexity, location and demonstrationof connection to urethra was 89%, 67%, 67%, and 56%, respectively. Alternative diagnosis solely by MRIincluded vaginal wall cysts (3 cases), endometriosis (1 case) and ectopic ureter (1 case). No periurethrallesion was found by either modality in 2 cases.The correlation between MRI and DBU in diagnosing female periurethral lesions is very good foranatomical delineation of diverticula. MRI, which does not involve radiation, may also indicate alternativediagnoses that can contribute to proper patient management.