Marco Di Girolamo MD, Presenter: Nothing to Disclose

Alberto Trucchi, Abstract Co-Author: Nothing to Disclose

Ines Casazza, Abstract Co-Author: Nothing to Disclose

Matteo Cappucci MD, Abstract Co-Author: Nothing to Disclose

Andrea Tubaro, Abstract Co-Author: Nothing to Disclose

Vincenzo David MD, Abstract Co-Author: Nothing to Disclose

To evaluate with MRI male patients with urinary bladder neck dysfunction, studying the anatomical aspect of bladder neck and performing voiding MR-cystourethrography.

We have evaluated with MRI 21 male patients with urinary bladder neck dysfunction diagnosed with pressure-flow study. All the patients had undergone US in the month proceeding MRI and patients with BPH were excluded. The MR examinations were performed with an 1.5 Tesla superconductive magnet with the patient placed in supine position and using a phased-array body coil. The patients had urine-filled bladders and sagittal and oblique coronal TSE T2-weighted scans were performed (TR:6250ms; TE:90ms;sl.thick.:3mm; acq.time:3’38”). The oblique coronal scans were parallel to the plane of the bladder neck. 15 patients underwent also voiding MR-cystourethrography performed with T1-weighted spoiled 3D gradient-echo acquisitions on sagittal plane performed (TR:12ms; TE:2,7ms; flip-angle:40°; sl.thickness: 2mm; acq.time:12s) after the filling of bladder lumen with contrast-material-enhanced urine obtainded by the i.v administration 20 mg of furosemide followed by the i.v. administration of ¾ of the normal dose of a paramagnetic contrast agent (Magnevist, Bayer Pharma, Germany).

The entire MR examination lasted no longer than 10 minutes for each patient. We detected 18 patients with abnormality of smooth muscular structures of the bladder neck and 3 patients with bladder neck cyst. MRI allowed a perfect evaluation of the different smooth detrusor muscles of the bladder neck. In patients with the typical urinary bladder neck dysfunction, we detected the hypertrophy of posterior smooth muscular structures of bladder neck and the kyphosis of prostatic urethra. Only 6 patients were able to perform voiding MR-cystourethrography that showed the characteristic radiological features.

MRI with voiding MR-cystourethrography could be performed in male patients with bladder outlet obstruction in order to visualize the anatomical aspect of the bladder neck. These anatomical information are useful to determine the causes of voiding obstruction, to diagnose urinary bladder dysfunction and to establish the best therapeutic approach.

MRI with voiding MR-cystourethrography could be performed to diagnose urinary bladder neck dysfunction and can substitute conventional retrograde and voiding cystourethrography

Di Girolamo, M, Trucchi, A, Casazza, I, Cappucci, M, Tubaro, A, David, V, Urinary Bladder Neck Dysfunction in Male Patients: Evaluation with MRI and with Voiding MR-Cystourethrography.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13019569.html