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Cross-sectional Imaging of the Female Urethra: Technique and Results¹

¹ From the Department of Radiology, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78229 (S.R.P.); and the Department of Radiology, Mallinckrodt Institute of Radiology, St Louis, Mo (C.O.M., V.R.N., W.D.M., G.M., N.S., J.P.H., C.L.S.). Recipient of a Certificate of Merit award and an Excellence in Design award at the 2002 RSNA Scientific Assembly. Received April 12, 2004; revision requested July 27 and received October 19; accepted October 20. All authors have no financial relationships to disclose. Address correspondence to S.R.P. (e-mail: prasads{at}uthscsa.edu).

Clinical assessment of women with urethral symptoms is difficult, necessitating further evaluation with imaging. Urethrography provides limited information on luminal abnormalities of the urethra. Recent advances in ultrasound (US) and magnetic resonance (MR) imaging have dramatically improved evaluation of the female urethra, clarifying findings at physical examination and providing accurate road maps for surgeons. High-resolution transvaginal US, transperineal US, and transurethral US are reliable techniques for diagnosis and characterization of urethral abnormalities. High-resolution multiplanar MR imaging with phased-array pelvic and endovaginal coils demonstrates the urethral anatomy in greater detail. In women with urethral diverticula, US and MR imaging demonstrate the number of diverticula and the location, size, configuration, and possible contents of the sac. Most important, the position of the neck of the diverticulum may be identified for the surgeon. Imaging features do not allow differentiation between histologic subtypes of urethral carcinoma; the diagnosis is established with histopathologic examination. Periurethral cysts do not communicate with the urethra and therefore can often be differentiated from urethral diverticula at endocavitary MR imaging. High-resolution multiplanar US and MR imaging allow comprehensive evaluation of abnormalities of the female urethra.

© RSNA, 2005

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