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MRI of acquired posterior urethral diverticulum following surgery for anorectal malformations

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Abstract

Background

Posterior urethral diverticulum (PUD) is one of the most common postoperative complications associated with anorectal malformation (ARM) correction.

Objective

To describe our MRI protocol for evaluating acquired PUD following ARM surgery, and associated imaging findings.

Materials and methods

Two radiologists retrospectively reviewed 61 pelvic MRI examinations performed for postoperative ARM for PUD identification and characteristics. Associated clinical, operative and cystoscopy reports were also reviewed and compared to MRI.

Results

An abnormal retrourethral focus suspicious for PUD was identified at MRI in 13 patients. Ten of these patients underwent subsequent surgery or cystoscopy, and PUD was confirmed in five. All of the confirmed PUD cases appeared as cystic lesions that were at least 1 cm in diameter in two imaging planes. Four of the false-positive cases were punctate retrourethral foci that were visible only on a single MRI plane. One patient had a seminal vesical cyst mimicking a PUD.

Conclusion

Pelvic MRI can be a useful tool in the postoperative assessment of suspected PUD associated with ARM. Radiologists should have a high clinical suspicion for a postoperative PUD when a cystic lesion posterior to the bladder/posterior urethra is encountered on two imaging planes in these patients.

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Author notes

  1. Nicholas C. Weaver

    Present address: Vanderbilt University, Nashville, TN, USA

  2. Taiwo Lawal

    Present address: Department of Surgery, University College Hospital, Ibadan, Nigeria

Authors and Affiliations

  1. Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA

    Daniel J. Podberesky, Nicholas C. Weaver & Christopher G. Anton

  2. Department of Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Taiwo Lawal, Miller C. Hamrick, Alberto Peña & Marc A. Levitt

  3. Department of Urology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Shumyle Alam

Authors
  1. Daniel J. Podberesky
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  2. Nicholas C. Weaver
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  3. Christopher G. Anton
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  4. Taiwo Lawal
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  5. Miller C. Hamrick
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  6. Shumyle Alam
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  7. Alberto Peña
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  8. Marc A. Levitt
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Corresponding author

Correspondence to Daniel J. Podberesky.

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Podberesky, D.J., Weaver, N.C., Anton, C.G. et al. MRI of acquired posterior urethral diverticulum following surgery for anorectal malformations. Pediatr Radiol 41, 1139–1145 (2011). https://doi.org/10.1007/s00247-011-2072-9

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  • DOI: https://doi.org/10.1007/s00247-011-2072-9

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