Urethra MRI Protocol

Normal "Urethra MRI Protocol" Sequences

• Axial T2 Single Shot FSE
• Coronal T2 Single Shot FSE  
• Axial T2 FSE  (TSE) 3 mm with 0.2 gap.
• Coronal T2 FSE  (TSE) or we can use HASTE Including a kidneys-optional renal survey
• Sagittal T2 FSE  (TSE) 
• Axial   2D dual-echo gradient-echo (TR range/first-echo TE, second-echo TE, 160–200/2.4, 5.2; flip angle, 90°) in-phase and opposed-phase T1-weighted imaging.
• Axial DYNAMIC LAVA /THRIVE / VIBE) (PRE-CONTRAST) 
• Sagittal POST CONTRAST LAVA/ THRIVE / VIBE) Scan delay = 45 sec.2 measures (0 and 180 sec).

Optional "Urethra MRI Protocol" Sequences

• Dynamic true FISP Sag One sag image per second for 60 second Instruct patient to relax, then  valsalva , then relax, then Kegel

Imaging notes for "Urethra MRI Protocol"

• T1 : T1 sequences before IV administration are not considered very useful. 
  • a diverticulum or urethrocoele is T1 hypo intense.
• T2 : T2 imaging is the preferred technique:
  • often shows presence of hyperintense fluid in a diverticulum
  • diverticulum with circumferential involvement is described as "saddle bag diverticulum"
• T1 + C (Gd) 
  • IV gadolinium can be administered for detection of inflammation or infection
  • it can also aid in the diagnosis of the rare diverticular adenocarcinoma.
  • malignancy can be visualized as enhancing soft tissue within the diverticulum

• The multiple orthogonal planes (axial, sagittal, and coronal) used in phased-array MR imaging are useful for evaluating the orientation of a urethral diverticulum.
• The intravenous administration of gadolinium-based contrast material is helpful in differentiating inflammation from malignancy in a urethral diverticulum. 
• Enhancement of the submucosal layer is seen after intravenous gadolinium-based contrast material administration.  
• T2-weighted imaging is preferred for the detection of hyperintense fluid in a diverticulum. 
• A diverticulum with circumferential involvement of the urethra may be seen (“saddle bag diverticulum”). Intravenous gadolinium-based contrast material administration aids in the detection of inflammation and of the rare diverticular adenocarcinoma.If contrast material was indicated, the 3D gradient-echo sequence was repeated after administration of a single dose of gadolinium contrast material 

Imaging planes for "Urethra MRI Protocol"
Axial: Orient perpendicular to urethra; cover from bladder base to meatus 

Urethra is normal. Note mild descent of urethra (dotted line), vagina (V), and anorectal junction (arrow) below pubococcygeal line (solid line). Urinary bladder (B) is located above pubococcygeal line.


Normal Urethra MRI Protocol
Coronal T2-weighted MRI shows measurement of membranous urethral length.