Chou Chen-Pin, Levenson Robin B, Elsayes Khaled M, Lin Yih-Huie, Fu Ting-Ying, Chiu You-Shin, Huang Jer-Shyung, Pan Huay-Ben
Department of Radiology and Institute of Clinical Medicine, Kaohsiung Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan, Republic of China.
Radiographics. 2008 Nov-Dec;28(7):1917-30. doi: 10.1148/rg.287075076.
Female urethral diverticulum is an uncommon pathologic entity and can manifest with a variety of symptoms involving the lower urinary tract. Selection of the appropriate imaging modality is critical in establishing the diagnosis. Urethrography has traditionally been used in the evaluation of urethral diverticulum but provides only intraluminal information. Ultrasonography is advantageous in that it does not involve ionizing radiation and has the capacity to help detect a diverticulum without contrast agent filling. Multidetector computed tomographic (CT) voiding urethrography yields urethral images during micturition. In addition, the diverticulum and diverticular orifice can be visualized on two- and three-dimensional reformatted CT images. Interactive virtual urethroscopy provides simulated visualization of the intraluminal anatomy and the diverticular orifice. New magnetic resonance imaging techniques that make use of a surface or endoluminal coil have higher diagnostic accuracy and can delineate the diverticular cavity and help detect related complications. Clinicians should consider the possibility of a urethral diverticulum in women with chronic or recurrent lower urinary tract symptoms. Moreover, because female urethral diverticulum is becoming more prevalent in clinical practice, radiologists should be familiar with its imaging features and with the imaging techniques that are optimal for its evaluation.
女性尿道憩室是一种罕见的病理实体，可表现为涉及下尿路的多种症状。选择合适的成像方式对于确立诊断至关重要。尿道造影传统上用于评估尿道憩室，但仅提供腔内信息。超声检查的优势在于它不涉及电离辐射，并且有能力在不注入造影剂的情况下帮助检测憩室。多排螺旋计算机断层扫描（CT）排尿尿道造影可在排尿期间生成尿道图像。此外，憩室和憩室口可在二维和三维重建CT图像上显示。交互式虚拟尿道镜检查可提供腔内解剖结构和憩室口的模拟可视化。利用表面或腔内线圈的新型磁共振成像技术具有更高的诊断准确性，能够描绘憩室腔并有助于检测相关并发症。临床医生应考虑慢性或复发性下尿路症状女性患者存在尿道憩室的可能性。此外，由于女性尿道憩室在临床实践中越来越普遍，放射科医生应熟悉其成像特征以及最适合评估它的成像技术。
