Axial T2 TSE WI
A 45-year-old female with a 3 month history of dyspareunia and urinary urgency.
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 , and is common at patients between 30-50 years old .
Clinical findings are: dysuria, dyspareunia and drip post voiding .
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 .
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 .
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].
 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)
 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)
 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)
 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)