EURORAD ESR

Case 14166

Saddlebag diverticulum of the female urethra

Author(s)
Tonolini Massimo, MD.

"Luigi Sacco" University Hospital, Radiology Department; Via G.B. Grassi 74 20157 Milan, Italy; Email:mtonolini@sirm.org
 
Patient
female, 75 year(s)
 
 
  • Figure 1
    Pelvic MRI - unenhanced images
     

    Sagittal (a,b), coronal (c,d) and axial (e,f) T2-weighted images showed a large, well-demarcated saddlebag-shaped lesion (*) with fluid-like signal intensity measuring 5.5 cm longitudinal diameter, which caused mild...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    The well-demarcated, saddlebag-shaped fluid-like lesion (*) caused mild upward bladder (§) displacement , encircled most of the urethra (thin arrows) along its entire length. Note small-sized hypointense intramural...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    The saddlebag-shaped well-demarcated lesion (*) showed fluid-like signal intensity, thin septations, measured 5.5 cm longitudinal diameter and caused mild upward bladder (§) displacement. No adnexal abnormalities.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    The well-demarcated saddlebag-shaped lesion (*) showed homogeneous fluid-like signal intensity, minimally displaced the urethra (thin arrows). Contralaterally, and upwards the urinary bladder (§).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    The well-demarcated saddlebag-shaped lesion (*) showed homogeneous fluid-like signal intensity, measured 4 cm maximum transverse diameter, encircled most of the urethra (thin arrows) and minimally displaced it...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    The well-demarcated saddlebag-shaped lesion (*) showed homogeneous fluid-like signal intensity, minimal septations, encircled most of the urethra (thin arrows) with probable thin connection (arrowhead) at the 6...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    The cyst-like periurethral lesion (*) showed homogeneous fluid-like low T1-weighted signal intensity (g), non-restricted diffusion (h) with normal apparent diffusion coefficient (ADC) values of fluid (i).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    The cyst-like periurethral lesion (*) showed homogeneous fluid-like low T1-weighted signal intensity (g), non-restricted diffusion (h) with normal apparent diffusion coefficient (ADC) values of fluid (i).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    The cyst-like periurethral lesion (*) showed homogeneous fluid-like low T1-weighted signal intensity (g), non-restricted diffusion (h) with normal apparent diffusion coefficient (ADC) values of fluid (i).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    Additionally, fat-suppressed T2-weighted images excluded inflammatory changes of the fat planes (+) surrounding the saddlebag-shaped periurethral cystic lesion (*). Note urethra (thin arrow).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;
     
     
  • Figure 2
    Pelvic MRI - post-gadolinium fat-suppressed images
     

    On sagittal (a) and axial (b) images, the periurethral cystic-like lesion (*) showed mild, thin and uniform peripheral enhancement after intravenous gadolinium, without inflammatory hyperaemia of the surrounding fat...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    The periurethral cystic-like lesion (*) showed mild, thin and uniform peripheral enhancement after intravenous gadolinium, without inflammatory hyperaemia of the surrounding fat planes (+). Note urethra (thin Arrow).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Diverticula;
     
     
  • Figure 3
    Transvaginal ultrasound
     

    Repeated ultrasound confirmed a homogeneously anechoic fluid-containing periurethral lesion (*) with a single communication with the urethra (arrowhead in b). Note urine-filled bladder (§).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Diverticula;

    Repeated ultrasound confirmed a homogeneously anechoic fluid-containing periurethral lesion (*) with a single communication with the urethra (arrowhead in b). Note urine-filled bladder (§).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Diverticula;
     
     
Sagittal (a,b), coronal (c,d) and axial (e,f) T2-weighted images showed a large, well-demarcated saddlebag-shaped lesion (*) with fluid-like signal intensity measuring 5.5 cm longitudinal diameter, which caused mild upward displacement of the bladder (§).
 
The well-demarcated, saddlebag-shaped fluid-like lesion (*) caused mild upward bladder (§) displacement , encircled most of the urethra (thin arrows) along its entire length. Note small-sized hypointense intramural uterine leiomyoma.
 
The saddlebag-shaped well-demarcated lesion (*) showed fluid-like signal intensity, thin septations, measured 5.5 cm longitudinal diameter and caused mild upward bladder (§) displacement. No adnexal abnormalities.
 
The well-demarcated saddlebag-shaped lesion (*) showed homogeneous fluid-like signal intensity, minimally displaced the urethra (thin arrows). Contralaterally, and upwards the urinary bladder (§).
 
The well-demarcated saddlebag-shaped lesion (*) showed homogeneous fluid-like signal intensity, measured 4 cm maximum transverse diameter, encircled most of the urethra (thin arrows) and minimally displaced it contralaterally.
 
The well-demarcated saddlebag-shaped lesion (*) showed homogeneous fluid-like signal intensity, minimal septations, encircled most of the urethra (thin arrows) with probable thin connection (arrowhead) at the 6 o'clock position.
 
The cyst-like periurethral lesion (*) showed homogeneous fluid-like low T1-weighted signal intensity (g), non-restricted diffusion (h) with normal apparent diffusion coefficient (ADC) values of fluid (i).
 
The cyst-like periurethral lesion (*) showed homogeneous fluid-like low T1-weighted signal intensity (g), non-restricted diffusion (h) with normal apparent diffusion coefficient (ADC) values of fluid (i).
 
The cyst-like periurethral lesion (*) showed homogeneous fluid-like low T1-weighted signal intensity (g), non-restricted diffusion (h) with normal apparent diffusion coefficient (ADC) values of fluid (i).
 
Additionally, fat-suppressed T2-weighted images excluded inflammatory changes of the fat planes (+) surrounding the saddlebag-shaped periurethral cystic lesion (*). Note urethra (thin arrow).
 
On sagittal (a) and axial (b) images, the periurethral cystic-like lesion (*) showed mild, thin and uniform peripheral enhancement after intravenous gadolinium, without inflammatory hyperaemia of the surrounding fat planes (+).
 
The periurethral cystic-like lesion (*) showed mild, thin and uniform peripheral enhancement after intravenous gadolinium, without inflammatory hyperaemia of the surrounding fat planes (+). Note urethra (thin Arrow).
 
Repeated ultrasound confirmed a homogeneously anechoic fluid-containing periurethral lesion (*) with a single communication with the urethra (arrowhead in b). Note urine-filled bladder (§).
 
Repeated ultrasound confirmed a homogeneously anechoic fluid-containing periurethral lesion (*) with a single communication with the urethra (arrowhead in b). Note urine-filled bladder (§).
 
 
 
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