Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug;40(6):1441-1449.
doi: 10.1002/nau.24674. Epub 2021 May 26.

Evaluation of the female bladder neck and urethra using MRI with fiber tractography: Prospective study on a large cohort of continent women

Catherine Roy  1 , Mickael Ohana  1 , Aissam Labani  1 , Thibault Tricard  2 , Christian Saussine  2 , Pierre Leyendecker  1
Affiliations

Evaluation of the female bladder neck and urethra using MRI with fiber tractography: Prospective study on a large cohort of continent women

Catherine Roy et al. Neurourol Urodyn. 2021 Aug.

Abstract

Aims: To prospectively evaluate the performance of a last generation magnetic resonance imaging (MRI) device with tractography to identify the normal female urethral sphincters in terms of morphology and quantification on a large cohort of continent women.

Methods: We have recorded the data of 75 continent women who underwent a diffusion tensor imaging (DTI) sequence with fiber tractography during a pelvic MR examination. Three groups of age were analyzed in terms of color fiber tracking quality and quantitative parameters (fractional anisotropy [FA] and mean diffusibility [MD]). Statistical analysis was done for the qualitative assessment using weighted kappa statistics of Cohen and for the quantitative parameters using a non-parametric Kruskal-Wallis test.

Results: For all cases, fiber-tracking resulted in a satisfactory representation of the complexity of the orientation of the fibers. The interobserver concordance of qualitative data was substantial, calculated at 0.78 (confidence interval: 0.71-0.85). For FA, there was no statistically significant difference with the age between the three urethral segments (p > 0.05). However, we registered a significant difference inside each group between the different segments (p < 0.05), corresponding to different orientation of fibers. For MD, we have found a statistically significant difference both between levels inside each group and according the age, meaning a variation of the water mobility for each type of musculature and with age (p < 0.05).

Conclusion: DTI with fiber tractography performed on a recent MR unit is a robust method for the three-dimensional visualization of the details and connections of the urethral female sphincters. Quantitative variations with age need to be considered.

Keywords: diffusion tensor imaging (DTI); female urethra; fiber tractography; magnetic resonance imaging (MRI).

PubMed Disclaimer

References

REFERENCES

    1. Gil Vernet S Morphology and Function of the Vesico-Prostato-Urethral Musculature. Edizioni Canova, Treviso, Italy 1968.
    1. Huisman AB . Aspects on the anatomy of the female urethra with special relation to urinary continence. Contrib Gynecol Obstet. 1983;10:1-31.
    1. Oelrich TM . The striated urogenital sphincter muscle in the female. Anat Rec. 1983;205:223-232.
    1. Colleselli K , Stenzl A , Eder R , Strasser H , Poisel S , Bartsch G . The female urethral sphincter: a morphological and topographical study. J Urol. 1998;160:49-54.
    1. Yucel S , Baskin LS . An anatomical description of the male and female urethral sphincter complex. J Urol. 2004;171:1890-1897.

LinkOut - more resources