Nueva técnica para realizar uretro-TC y uretro-RMel método Clamp

Abstract

Urethral stricture is one of the most common disorders of the male urethra. The clinical presentation is variable, and at times there are associated disorders; everything contributes to a significant decrease in the quality of life of those who suffer from it, since, in addition, the recurrence rate is high, due to the fact that it can be complex. In response to meet the need to obtain information that cannot be provided optimally in all cases by retrograde urethrography (RUG), more and more techniques such as retrograde urethrosonography (RUS, gold standard), and, more recently, computed-tomography retrograde urethrography (CT-RUG) and magnetic resonance retrograde urethrography (MR-RUG), are being used (these last two also allow periurethral tissues to be evaluated, and associated anomalies to be assessed such as fistulas, diverticula, false pathways, and entities that may require more tests than RUG and RUS), in furtherance of improving preoperative information for subsequent surgical planification. CT-RUG and MR-RUG have been performed, with the design of a specific and rapid MRU protocol, which uses the 3D Magnetic resonance cholangiopancreatography (MRCP) cholangiopancreatography sequence (3D MRCP), usually included in the MRI-cholangio protocol, but applied to evaluate the urethral lumen; The technique used to achieve urethral distension has been the clamp method with the B-Ring device, which has been a simple procedure, essentially painless and comfortable for the patient. CT-RUG allows post-processing reconstruction and MR-RUG has multiplanar capacity and optimal tissue contrast. Both techniques were fast, with a mean time in CT-RUG of 6.1 minutes and in MR-RUG it was 11.27 minutes to apply the proposed sequential URM protocol. There is full correlation between RUS and 3D-MRI findings. RUG was not sensitive in detecting periurethral pathology; RUS and MR-RUG were able to detect and determine the existing pathology. The spongiofibrosis recorded quantitatively in RUS and coronal T2 with fat suppression shows very similar thickness measurements in both techniques. To that end, CT-RUG and MR-RUG performed with the clamp method provide additional relevant information to that provided by RUG and RUS in complex cases and/or with urethromeatal pathology.