Figure 1
Teaching Case
SectionUroradiology & genital male imaging
Case TypeClinical Cases
Authors
Alejandro Rodriguez 1, Yanet Torres
Connected authors
45 years, female
A 45-year-old female with a 3 month history of dyspareunia and urinary urgency.
Urethral diverticulum
Vaginal wall cyst
Skene duct cyst
MRI shows a septated U-shaped T2-hyperintense lesion (blue arrows, Fig. 1, 3) surrounding the posterior aspect of the urethra (red arrow, Fig. 1, 2) at the level of the pubic symphysis.
Urethral diverticulum is a focal dilatation of the wall of the urethra, which is in communication with the urethral lumen [1], and is common at patients between 30-50 years old [2].
Clinical findings are: dysuria, dyspareunia and drip post voiding [3].
MRI shows a cystic lesion, high T2/low T1 signal intensity, arising from the posterolateral aspect of the urethra at the level of the pubic symphysis, usually surrounding in different degrees the urethra [3].
If there is debris, it could show a high signal intensity on T1.
Post-contrast images and diffusion help to detect inflammatory changes or associated malignant lesions [1].
Surgical planning requires to evaluate the location (using clock template in axial plane), size, configuration (simple or multicystic appearance) and position of the neck [3, 4].
References
[1] Chou CP, Levenson RB, Elsayes KM, Lin YH, Fu TY, Chiu YS, Huang JS, Pan HB. (2008) Imaging of female urethral diverticulum: an update. Radiographics 28(7):1917-30. (PMID: 19001648)
[2] Dwarkasing RS, Dinkelaar W, Hop WC, Steensma AB, Dohle GR, Krestin GP. (2011) MRI Evaluation of Urethral Diverticula and Differential Diagnosis in Symptomatic Women. AJR Am J Roentgenol 197(3):676-82. (PMID: 21862811)
[3] Chaudhari VV, Patel MK, Douek M, Raman SS. (2010) MR Imaging and US of Female Urethral and Periurethral Disease. Radiographics 30(7):1857-74. (PMID: 21057124)
[4] Prasad SR, Menias CO, Narra VR, Middleton WD, Mukundan G, Samadi N, Heiken JP, Siegel CL. (2005) Cross-sectional Imaging of the Female Urethra: Technique and Results. Radiographics 25(3):749-61. (PMID: 15888623)
Case information
| URL: | https://www.eurorad.org/case/15195 |
| DOI: | 10.1594/EURORAD/CASE.15195 |
| ISSN: | 1563-4086 |
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
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Figure 1
Department of Radiology, Clínica Ricardo Palma, Lima, Perú.
Figure 2
Department of Radiology, Clínica Ricardo Palma, Lima, Perú.
Figure 3
Department of Radiology, Clínica Ricardo Palma, Lima, Perú.