Urethral diverticulum

Clinical History: 
46 year old female with complaints of dysuria and dyspareunia. Clinical consideration included a possible urethrocele. On physical examination no urethrocele was seen or palpated. Some tenderness was present in the urethra near the bladder neck. No purulent fluid was expressed from urethra. Cystoscopy was not diagnostic. CT scan of abdomen and pelvis showed a possible urethral diverticulum. Pathology showed urethral diverticulum with granulation tissue associated with acute and chronic inflammation.

Diagnosis:
Urethral diverticulum.

MR Technique: 
3 T (Siemens Verio) with body coil. Image 1: Coronal fat sat pre-contrast T2 weighted (TR/TE 1200/111 ms, slice thickness 1 mm, scan time 5 min 53 sec); Image 2: Sagittal T1 weighted pre-contrast VIBE fat sat (TR/TE 4.6/2.0 ms, slice thickness 3 mm, scan time 19 sec); Image 3: Sagittal T1 weighted post contrast VIBE fat sat (TR/TE 4.6/2.0 ms, slice thickness 3 mm, scan time 19 sec) Image 4: Axial T1 weighted post contrast VIBE fat sat (TR/TE 4.6/2.0 ms, slice thickness 3 mm, scan time 19 sec).

Imaging Findings:
A cystic lesion is seen adjacent to the urethra to the right, with a medial/anterior solid component. The cystic component of the lesion shows low signal on T1 W and high signal on T2 W (suggestive of fluid); the solid component demonstrates low signal on T2 W and intermediate signal on T1 W with suggestion of enhancement on post contrast. Peripheral enhancement of the cystic lesion is also evident. The overall measurements of the cystic lesion are 2.8 x 3.4 x 3.3 cm (CC x TRANS x AP) and the soft tissue component measures up to 1.2 cm in maximum diameter.