Answer for BIR CoW 02 Oct 2022
MR Urethrogram - Urethral Stricture
Findings:
Contrast is well visualized in Penile and distal bulbar urethra. T1 T2 hypointense stricture noted in bulbomembranous urethra of length 2.25 cm with inner luminal diameter of 3.5 mm.
Discussion:
The approximate length of male urethra is 18 to 20 cm and it runs from the bladder to the outer urethral meatus In 19th century, imaging techniques of retrograde urethrography (RGU) and micturition cystourethrography (MCU) were invented, and also regarded as standard imaging modality for the morphologic and functional study of the urethra for nearly about centuary The radiographic urethrography is an invasive, expensive, tedious technique. Though it has been considered as standard technique for the evaluation of pre operative male urethra, there were several limitations associated with it, as it poses the risk of radiation it is not recommended to repeat whenever required, it has failed to demonstrate periurethral abnormality as a cause of urethral lesion Advantages of Mr urethrogram over AUG are as follows Provides better delineation of length of stricture and its anatomy . Demonstrates periurethral fibrosis better than AUG . Provides better anatomy of posterior urethra compared to AUG No risk of radiation
References:
1. Yoshifumi Narumi, Hedvig Hricak, Armenakas NA et al. MR imaging of traumatic posterior urethral injury. Radiology 188 : 439-443, 1993.
2. Christopher M, Dixon, Hedvig Hricak, Jack W. McAninch, MR imaging of traumatic posterior urethral distraction defects and pelvic crush injuries. J Urol 148: 1162-1165, 1992.
3. Semelka R, Hricak H, Kim B, et al. Pelvic fistulas: appearance on MR images. Abdom Imaging. 1997;22:91–95.
Findings:
Contrast is well visualized in Penile and distal bulbar urethra. T1 T2 hypointense stricture noted in bulbomembranous urethra of length 2.25 cm with inner luminal diameter of 3.5 mm.
Discussion:
The approximate length of male urethra is 18 to 20 cm and it runs from the bladder to the outer urethral meatus In 19th century, imaging techniques of retrograde urethrography (RGU) and micturition cystourethrography (MCU) were invented, and also regarded as standard imaging modality for the morphologic and functional study of the urethra for nearly about centuary The radiographic urethrography is an invasive, expensive, tedious technique. Though it has been considered as standard technique for the evaluation of pre operative male urethra, there were several limitations associated with it, as it poses the risk of radiation it is not recommended to repeat whenever required, it has failed to demonstrate periurethral abnormality as a cause of urethral lesion Advantages of Mr urethrogram over AUG are as follows Provides better delineation of length of stricture and its anatomy . Demonstrates periurethral fibrosis better than AUG . Provides better anatomy of posterior urethra compared to AUG No risk of radiation
References:
1. Yoshifumi Narumi, Hedvig Hricak, Armenakas NA et al. MR imaging of traumatic posterior urethral injury. Radiology 188 : 439-443, 1993.
2. Christopher M, Dixon, Hedvig Hricak, Jack W. McAninch, MR imaging of traumatic posterior urethral distraction defects and pelvic crush injuries. J Urol 148: 1162-1165, 1992.
3. Semelka R, Hricak H, Kim B, et al. Pelvic fistulas: appearance on MR images. Abdom Imaging. 1997;22:91–95.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!