1882 AJR:184, June 2005
AJR 2005;184:1882–1888
0361–803X/05/1846–1882
© American Roentgen Ray Society
Genitourinary Imaging
Chou et al.
CT Urethrography and Virtual
Urethroscopy
Original Report
Chen-Pin Chou
1
Jer-Shyung Huang
1
Ming-Ting Wu
1,2
Huay-Ben Pan
1,2
Fong-Dee Huang
3
Chia-Cheng Yu
3
Chien-Fang Yang
1,2
Chou C-P, Huang J-S, Wu M-T, Pan H-B, Huang F-D, Yu C-C, Yang C-F
Received January 18, 2004; accepted after revision
September 15, 2004.
Supported by Kaohsiung Veterans General Hospital
research program (VGHKS93-82).
1
Department of Radiology, Kaohsiung Veterans General
Hospital, 386 Da-Chung First Rd., Kaohsiung 813, Taiwan,
ROC. Address correspondence to C.-P. Chou
(r2207759@ms19.hinet.net).
2
National Yang-Ming University School of Medicine,
Taipei, Taiwan, ROC.
3
Department of Urology, Kaohsiung Veterans General
Hospital, Kaohsiung, Taiwan, ROC.
CT Voiding Urethrography and
Virtual Urethroscopy: Preliminary
Study with 16-MDCT
OBJECTIVE. The purpose of this study was to demonstrate CT voiding urethrography and
CT virtual urethroscopy. Fourteen CT voiding urethrography examinations on 13 men (mean
age, 30 years) were prospectively performed with 16-MDCT. The clinical diagnoses of those
patients included urethral injury, urethral stricture, and hypospadia. The CT voiding urethro-
gram was obtained with transverse CT of the voiding, contrast-filled urethra and display of 2D
multiplanar and 3D virtual images.
CONCLUSION. The full urethral structure was clearly shown by CT voiding urethrog-
raphy and virtual urethroscopy in all patients. The results of CT voiding urethrography and con-
ventional methods correlated closely with the urethral diseases being imaged.
ost diagnostic imaging of the
urethra continues to be per-
formed using conventional radi-
ography with luminal distention
by iodine contrast media. However, radio-
graphic contrast material–enhanced studies
are invasive and do not provide information
about periurethral tissue. Other, more mod-
ern imaging techniques such as sonography
and MRI can contribute, in some specific
circumstances, to the diagnosis of urethral
diseases. Sonography has a small field of
view, and the technique is operator-depen-
dent. MRI is not widely used to examine the
urethra because the technique is somewhat
complex and expensive. CT is used only
rarely to study the urethra. Its usefulness is
limited to the evaluation of inflammatory
fluid collections or the identification of gas
formed during necrosis or trauma [1]. Re-
cent advances in MDCT, rapid image acqui-
sition, and software have made 2D and 3D
reformatted images available for the newer
diagnostic techniques. These techniques
have been applied to many organs, includ-
ing the colon, bronchus, stomach, and uri-
nary bladder [2, 3].
The thin-section transverse images and
high scanning speed of CT have led to the de-
velopment of promising new techniques for
urethral evaluation: CT voiding urethrogra-
phy and virtual urethroscopy. With these
techniques, the voiding, contrast-filled ure-
thra is scanned with 16-MDCT in approxi-
mately 6 sec. Real-time 3D rendering of CT
images is performed to visually simulate ure-
throscopic examination. In this study, we in-
vestigated the technique of 16-MDCT in the
detection of urethral diseases.
Subjects and Methods
Patients
From January 2003 to May 2004, 13 men (age
range, 18–50 years; mean, 30 years) in whom ure-
thral diseases were suspected were referred from the
genitourinary or emergency department for urethral
imaging studies. In total, 14 CT voiding urethrogra-
phy examinations were performed. One man with
hypospadia underwent CT voiding urethrography
before and after surgery. The micturating condition
of patients was checked before examination. If the
patients reported an inability to void before and dur-
ing CT examination, they were not considered for
this study. Our series included suspected urethral in-
M
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