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Appropriateness Criteria

Reference Study Type Patients/Events Study Objective(Purpose of Study) Study Results Study Quality
10. Kodner CM, Thomas Gupton EK. Recurrent urinary tract infections in women: diagnosis and management. Am Fam Physician. 2010 Sep 15;82(6):638-43. Review/Other-Dx N/A To review diagnosis and management of recurrent urinary tract infections in women. No results stated in abstract. 4
14. Neal DE. Complicated urinary tract infections. Urol Clin North Am. 2008 Feb;35(1):13-22; v. Review/Other-Dx N/A To define complicated urinary tract infections. No results stated in abstract. 4
17. Haylen BT, Lee J, Husselbee S, Law M, Zhou J. Recurrent urinary tract infections in women with symptoms of pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(7):837-842. Observational-Dx 1,140 women Prospective urogynecological study assessing women and the prevalence of UTI. The overall prevalence of recurrent UTI was 19%. Significant positive associations of recurrent UTI were: Nulliparity with a 3.7 x (up to 50 years) increase over the prevalence for parous women and 1.8 x (over 50 years), Women with an immediate postvoid residual over 30 ml, which is significant in women over 50 years. The early age decline (18–45 years) in the prevalence of recurrent UTI might be related to increasing parity. The later increase (over 55 years) was probably due to the increasing postvoid residual effect superimposed on the nulliparity effect. 4
24. Committee Opinion No. 723: Guidelines for Diagnostic Imaging During Pregnancy and Lactation. Obstet Gynecol. 2017 Oct;130(4):e210-e216. Review/Other-Dx N/A Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. No results stated in abstract. 4
25. Tonolini M, Bianco R. Multidetector CT cystography for imaging colovesical fistulas and iatrogenic bladder leaks. Insights Imaging. 2012 Apr;3(2):181-7. Review/Other-Dx N/A To present our experience with multidetector computed tomography (MDCT) cystography applications outside the trauma setting, particularly for diagnosing bladder fistulas and leaks. No results stated in abstract. 4
26. Fananapazir G, Golshani B, Chen LX, McGahan JP, de Mattos AM, Corwin MT. Bladder debris on ultrasound in the emergency department: correlation with urinalysis. Abdom Radiol (NY). 2018 Sep;43(9):2462-2466. Review/Other-Dx N/A To evaluate the correlation between the presence of bladder debris on ultrasound and urinalysis results in the emergency department setting. The presence of bladder debris was associated with the presence of urobilinogen, nitrite, and white blood cells (p = < 0.0001, 0.0005, and 0.0004, respectively). 4
27. Lopes KR, Jorge BM, Barbosa MH, Barichello E, Nicolussi AC. Use of ultrasonography in the evaluation of urinary retention in critically ill patients. Rev Lat Am Enfermagem. 2023;31():e4026. Review/Other-Dx 37 patients To measure urinary volume through bladder ultrasound, performed by a nurse in critically ill patients, after removal of the indwelling urinary catheter and to verify the related factors on urinary retention. The 37 patients were mostly male, with a mean age of 54.9 years. The measurement of urinary volume by ultrasound ranged from 332.3 to 950 ml, and 40.54% of patients had urinary retention. Urinary retention was significantly associated with the occurrence of urinary tract infection, intestinal constipation and spontaneous overflow diuresis. Patients with urinary tract infection were 7.4 times more likely to have urinary retention 4
28. Fowler JE, Pulaski ET. Excretory urography, cystography, and cystoscopy in the evaluation of women with urinary-tract infection: a prospective study. N Engl J Med. 1981 Feb 19;304(8):462-5. Observational-Tx 104 Women To report a prospective study of findings with excretory urography, cystography, and cystoscopy in women with symptomatic urinary-tract infection and an analysis of the effects of the findings on treatment. Among 75 cystograms and 74 cystoscopies the only abnormalities that altered treatment of the infections were three instances of uretheral diverticula.  No abnormalities influencing treatment of the infections were found among 104 excretory urograms.  Incidental findings unrelated to urinary-tract infection but necessitating therapeutic intervention included a renal-cell carcinoma diagnosed by means of excretory urography and a transitional-cell carcinoma of the bladder discovered at cystoscopy. 2
29. Silverman SG, Leyendecker JR, Amis ES, Jr. What is the current role of CT urography and MR urography in the evaluation of the urinary tract? Radiology. 2009;250(2):309-323. Review/Other-Dx N/A To review the current role of urography in the post-IVU era and provide expository summaries of CT urography and MRU, while addressing the rationale, techniques, effectiveness, indications, and vulnerabilities of these newer modalities that have now become primary in imaging the urinary tract. CT urography is the current heir apparent to IVU, but because of its potential advantages, MRU may 1 day be the urographic test of choice particularly in young patients and patients who need repeated examinations. 4
30. Hooton TM. Recurrent urinary tract infection in women. Int J Antimicrob Agents. 2001 Apr;17(4):259-68. Review/Other-Dx N/A To review diagnosis and management of recurrent urinary tract infection in women. No results stated in abstract. 4
31. Amis ES, Jr., Cronan JJ, Pfister RC, Yoder IC. Ultrasonic inaccuracies in diagnosing renal obstruction. Urology. 1982;19(1):101-105. Review/Other-Dx 192 renal ultrasound examinations To review the many reported sonographic causes of false positive and false negative diagnoses of renal obstruction and discuss some recent observations on the renal sinus. Renal ultrasound is an excellent screening examination for suspected urinary tract obstruction. Its usefulness is based on the ability to detect hydronephrosis. However, it must be recognized that a significant number of conditions exist which can mimic or produce dilatation of the collecting system without urinary tract obstruction. Similarly, obstruction without hydronephrosis, although infrequent, exists. Situations causing either false positive or false negative renal sonograms are discussed. Renal sonography suggesting hydronephrosis should be followed with additional diagnostic studies to confirm or exclude obstruction. Similar persistence should be used when obstruction is strongly suggested clinically, and ultrasound fails to demonstrate hydronephrosis. 4
32. Denton T, Cochlin DL, Evans C. The value of ultrasound in previously undiagnosed renal failure. Br J Radiol. 1984;57(680):673-675. Review/Other-Dx 56 patients (109 kidneys) To assess the value of ultrasound in previously undiagnosed renal failure. All hydronephroses were accurately detected on ultrasound. 80% were due to obstruction, but showed no features that distinguished them from other causes of hydronephrosis. A diagnostic pathway is suggested. 4
33. Kamholtz RG, Cronan JJ, Dorfman GS. Obstruction and the minimally dilated renal collecting system: US evaluation. Radiology. 1989;170(1 Pt 1):51-53. Review/Other-Dx 370 patients To assess the significance of the ultrasonographic (US) demonstration of grade 1 hydronephrosis. In 80 patients, there was a clinical suspicion of renal obstruction. Grade 1 hydronephrosis was observed in 33 of the 80 patients, and obstruction was confirmed in 17 of those 33 patients (51.5%). In 290 patients, US was performed for reasons other than a suspicion of renal obstruction. Grade 1 hydronephrosis was observed in 37 of the 290 patients. Three of the 37 patients were excluded from further consideration due to lack of follow-up. Obstruction was confirmed in two of the remaining 34 patients (6%). It appears that grade 1 hydronephrosis is significant when the clinical question of renal obstruction is raised. 4
34. Choe JH, Lee JY, Lee KS. Accuracy and precision of a new portable ultrasound scanner, the BME-150A, in residual urine volume measurement: a comparison with the BladderScan BVI 3000. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(6):641-644. Observational-Dx 89 patients To determine the relative accuracy of a new portable ultrasound unit, BME-150A, and the BladderScan BVI 3000, as assessed in comparison with the catheterized residual urine volume. The ultrasound measurements were compared with the post-scan bladder volumes obtained by catheterization in the same patients. The ultrasounds were followed immediately (within 5 min) by in-and-out catheterizations while the patients were in a supine position. There were a total of 116 paired measurements made. The BME-150A and the BVI 3000 demonstrated a correlation with the residual volume of 0.92 and 0.94, and a mean difference from the true residual volume of 7.8 and 3.6 ml, respectively. Intraclass correlation coefficients for the accuracy of the two bladder scans were 0.90 for BME-150A and 0.95 for BVI 3000. The difference of accuracy between the two models was not significant (p = 0.2421). There were six cases in which a follow-up evaluation of falsely elevated post-void residual urine volume measurements on the ultrasound studies resulted in comparatively low catheterized volumes, with a range of differences from 66 to 275.5 ml. These cases were diagnosed with an ovarian cyst, uterine myoma, or uterine adenomyosis on pelvic ultrasonography. The accuracy of the BME-150A is comparable to that of the BVI 3000 in estimating the true residual urine volumes and is sufficient enough for us to recommend its use as an alternative to catheterization. 3
35. Ray AA, Ghiculete D, Pace KT, Honey RJ. Limitations to ultrasound in the detection and measurement of urinary tract calculi. Urology. 2010;76(2):295-300. Observational-Dx 60 patients To evaluate differences in stone measurement using computed tomography (CT) and ultrasound (US). Compared with CT, US overestimated stone size, an effect that was more pronounced with smaller calculi. The mean stone measurement on CT was 7.4 +/- 4.4 mm and on US it was 9.2 +/- 4.5 mm (P = .018). For stones 3
36. Sheafor DH, Hertzberg BS, Freed KS, et al. Nonenhanced helical CT and US in the emergency evaluation of patients with renal colic: prospective comparison. Radiology. 2000;217(3):792-797. Observational-Dx 45 patients Prospective comparison of nonenhanced helical CT and US for the depiction of urolithiasis. Diagnoses included 23 ureteral calculi and one each of renal cell carcinoma, appendicitis, ureteropelvic junction obstruction, renal subcapsular hematoma, cholelithiasis, medullary calcinosis, and myelolipoma. CT depicted 22 of 23 ureteral calculi (sensitivity, 96%). US depicted 14 of 23 ureteral calculi (sensitivity, 61%). Differences in sensitivity were statistically significant (P: =.02). Specificity for each technique was 100%. When modalities were compared for the detection of any clinically relevant abnormality (eg, unilateral hydronephrosis and/or urolithiasis in patients with an obstructing calculus), sensitivities of US and CT increased to 92% and 100%, respectively. One case of appendicitis was missed at US, whereas medullary calcinosis and myelolipoma were missed at CT. 1
37. Viprakasit DP, Sawyer MD, Herrell SD, Miller NL. Limitations of ultrasonography in the evaluation of urolithiasis: a correlation with computed tomography. J Endourol. 2012;26(3):209-213. Observational-Dx 72 patients To determine the correlation of ultrasonography (US) compared with noncontrast CT (NCCT) in detecting and determining size of stones. There were 203 urinary calculi in 90 urinary tracts identified on NCCT imaging. The sensitivity, specificity, and accuracy of detecting specific stones on US were 40%, 84%, and 53%. Correlation between US and NCCT findings decreased with smaller stone size and ureteral location and increased with right-sided laterality. For identified stones, larger stone size discrepancies were noted in up to one-third of stones on US. 3
38. Caoili EM, Cohan RH, Korobkin M, et al. Urinary tract abnormalities: initial experience with multi-detector row CT urography. Radiology. 2002 Feb;222(2):353-60. Observational-Dx 65 patients To evaluate MDCT urography for detection of urinary tract abnormalities. MDCT urography depicted many clinically diagnosed urinary tract abnormalities, including 15/16 uroepithelial malignancies, 5 congenital anomalies, 5 urinary tract calculi, and 18 calyceal and/or papillary, 30 renal pelvic and/or ureteral, and 25 bladder abnormalities. All abnormalities were detected on transverse images. These abnormalities included diffuse urothelial wall thickening in 4 patients (3 of whom had TCC), a renal abscess, a colovesical fistula, and incidentally detected extrarenal disease (a liver mass, hepatic metastases, lymph node metastases, an aortic dissection, and a pheochromocytoma; each of these findings was seen in one patient). 3
39. Chahine R, Mendiratta-Lala M, Consul N, et al. What can go wrong when doing right? A pictorial review of iatrogenic genitourinary complications. Abdom Radiol (NY). 2024 Nov;49(11):3987-4002. Review/Other-Dx N/A To review common and uncommon treatment-induced pathologies affecting the genitourinary system via a case-based approach. No results stated in abstract. 4
40. Kimura K, Yamamoto T, Tsuchiya J, et al. A diagnostic approach of various urethral diseases using multimodal imaging findings: comprehensive overview. Abdom Radiol (NY). 2024 Dec;49(12):4416-4436. Review/Other-Dx N/A To provide a comprehensive overview of urethral lesions, from traumatic changes to neoplasms, and discuss the multimodal imaging findings of various urethral lesions that radiologists should know. No results stated in abstract. 4
41. O'Shea A. Urologic Imaging: Infections and Inflammation. Urol Clin North Am. 2025 Feb;52(1):S0094-0143(24)00074-0. Review/Other-Dx N/A In the presence of confirmed or suspected complicated urinary tract infections, imaging to assess for underlying causes and complications is required. No results stated in abstract. 4
42. Majd M, Nussbaum Blask AR, Markle BM, et al. Acute pyelonephritis: comparison of diagnosis with 99mTc-DMSA, SPECT, spiral CT, MR imaging, and power Doppler US in an experimental pig model. Radiology. 2001; 218(1):101-108. Observational-Dx 35 piglets (70 kidneys) To compare Tc-99m DMSA SPECT, spiral CT, MRI, and power Doppler US for the detection and localization of acute pyelonephritis in piglets using histology as the standard of reference. 38/70 kidneys had pyelonephritis by histology. Sensitivity and specificity: 92% and 94% for SPECT DMSA. Sensitivity and specificity: 90% and 88% for MRI. Sensitivity and specificity: 87% and 88% for CT. Sensitivity and specificity: 74% and 57% for Doppler US. SPECT DMSA, MRI, and CT are equally sensitive and reliable for the detection of acute pyelonephritis. Doppler US is significantly less accurate. 2
43. Martina MC, Campanino PP, Caraffo F, et al. Dynamic magnetic resonance imaging in acute pyelonephritis. Radiol Med. 2010;115(2):287-300. Observational-Dx 442 consecutive renal MRI examinations (279 diagnostic and 163 follow-up) performed in 285 patients Retrospective study to evaluate the role and clinical impact of dynamic MRI in the diagnosis and follow-up of APN. MRI showed signal abnormalities suggestive of APN in 125/244 (51.2%) patients with native kidneys. Abscesses were present in 40/123 (32.5%) positive cases. During follow-up, complete normalization of MRI signs in 86/103 patients; 17/103 (16.5%) cases evolved into fibrosis and scarring. In 15/35 (42.8%) patients with transplanted kidney, MRI was positive for APN. Renal MRI is an effective tool for the diagnosis and follow-up of APN both in patients not at risk and those at higher risk, such as those with a transplanted kidney. 4
44. Leyendecker JR, Barnes CE, Zagoria RJ. MR urography: techniques and clinical applications. Radiographics. 2008; 28(1):23-46; discussion 46-27. Review/Other-Dx N/A To review techniques and clinical applications of MRU. MRU is clinically useful in the evaluation of suspected urinary tract obstruction, hematuria, and congenital anomalies, as well as surgically altered anatomy, and can be particularly beneficial in pediatric or pregnant patients or when ionizing radiation is to be avoided. 4
45. Lawrentschuk N, Ooi J, Pang A, Naidu KS, Bolton DM. Cystoscopy in women with recurrent urinary tract infection. Int J Urol. 2006;13(4):350-353. Observational-Dx 118 patients Retrospective study to determine if women with recurrent UTI warrant cystoscopy to exclude an abnormality of the lower urinary tract. Also, to correlate imaging and risk factors with cystoscopic findings to determine their predictive value in finding pathology. NPV of imaging was 99% and significant (P<0.01). Women with no risk factors for UTI had a NPV of 93% for normal cystoscopy (P>0.05). PPV was low for imaging and risk factors in predicting cystoscopy findings. In the study, 8% of women had significant abnormalities detected during cystoscopy with most over 50 years. Women without risk factors for recurrent UTI and with normal imaging could have a cystoscopy omitted. Younger women are less likely to have pathology and this must be factored into decisions to perform cystoscopy. 3
46. Shokeir AA, El-Diasty T, Eassa W, et al. Diagnosis of ureteral obstruction in patients with compromised renal function: the role of noninvasive imaging modalities. J Urol. 2004;171(6 Pt 1):2303-2306. Observational-Dx 149 patients (110 had bilateral obstruction and 39 had obstruction of a solitary kidney), 259 renal units Prospective study to compare the role of NCCT, MRU, and combined KUB and US in the diagnosis of the cause of ureteral obstruction in patients with compromised renal function. The gold standard included retrograde or antegrade ureterogram, ureteroscopy and/or open surgery. The definitive cause of ureteral obstruction was calculous in 146 and noncalculous in 113 renal units. The site of stone impaction was identified by NCCT in all 146 renal units (100% sensitivity), by MRU in 101 (69.2% sensitivity), and by combined KUB and US in 115 (78.7% sensitivity). Ureteral strictures were identified by NCCT in 18/65 cases (28%) and by MRU in 54/65 (83%). Overall of the 113 kidneys with noncalculous obstruction the cause could be identified by MRU in 101 (89% sensitivity), by NCCT in 45 (40% sensitivity), and by combined KUB and US in only 20 (18% sensitivity) with a difference of significant value in favor of MRU (P<0.001). In patients with renal impairment due to ureteral obstruction NCCT has superior diagnostic accuracy for detecting calculous causes of obstruction but MRU is superior for identifying noncalculous lesions. 3
47. Regan F, Kuszyk B, Bohlman ME, Jackman S. Acute ureteric calculus obstruction: unenhanced spiral CT versus HASTE MR urography and abdominal radiograph. Br J Radiol. 2005;78(930):506-511. Observational-Dx 64 patients To compare the performance of unenhanced spiral CT to the combination of HASTE MRU and KUB in patients suspected of having acute calculus ureteric obstruction. The presence of perirenal fluid, presence and level of ureteric obstruction and calculi were assessed on both techniques. 44/64 (69%) patients had acute calculus ureteric obstruction based on clinical, radiographic or surgical findings. MRU showed perirenal fluid in acute ureteric obstruction (77%) with a greater sensitivity than CT showed stranding (45%). The combination of fluid and ureteric dilation on MRU showed a sensitivity of 93% (CT 80%), specificity of 95% (CT 85%), and accuracy of 94% (CT 81%). There were 61 findings of either fluid or ureteric dilatation on MRU in 44 acutely obstructed kidneys compared with 37 similar findings on CT (P<0.005). Although there was excellent reproducibility (Kappa=0.75) in the finding of perirenal fluid on MRU, there was only fair interobserver agreement (Kappa<0.4) regarding perirenal stranding on CT. MRU/KUB showed ureteric calculi in 21/29 (72%) of patients with calculi seen by CT. Overall, MRU/KUB revealed 2.4 abnormalities per acutely obstructed ureter compared with 1.8 abnormalities detected by CT. 3
48. Odenrick A, Kartalis N, Voulgarakis N, Morsbach F, Loizou L. The role of contrast-enhanced computed tomography to detect renal stones. Abdom Radiol. 44(2):652-660, 2019 02. Observational-Dx 50 patients, 136 total stones. To investigate the detectability of renal stones in corticomedullary and nephrographic phases on contrast-enhanced computed tomography (CT). The ICC was 0.86. There was no statistically significant difference between corticomedullary and nephrographic phases (p = 0.94). The detection rate for stones measuring 3-5 mm was 82-88% and 98% for stones = 6 mm. 3
49. Smith RC, Verga M, McCarthy S, Rosenfield AT. Diagnosis of acute flank pain: value of unenhanced helical CT. AJR Am J Roentgenol. 1996;166(1):97-101. Observational-Dx 210 patients To determine the value of unenhanced CT in the diagnosis of acute flank pain. Sensitivity of 97%, specificity of 96%, and accuracy of 97% for diagnosis of ureteral stone disease. Unenhanced CT is an accurate technique. 2
50. Khati NJ, Sondel Lewis N, Frazier AA, Obias V, Zeman RK, Hill MC. CT of acute perianal abscesses and infected fistulae: a pictorial essay. Emerg Radiol. 2015 Jun;22(3):329-35. Review/Other-Dx N/A To demonstrate the usefulness of contrast-enhanced CT in the diagnosis of acute anorectal sepsis in the ER setting. We will discuss the CT appearance of infected fistulous tracts and abscesses and how CT imaging can guide the ER physician in the clinical management of these patients. No results stated in abstract. 4
51. Mandava A, Koppula V, Sharma G, Kandati M, Raju KVVN, Subramanyeshwar Rao T. Evaluation of genitourinary fistulas in pelvic malignancies with etiopathologic correlation: role of cross sectional imaging in detection and management. British Journal of Radiology. 93(1111):20200049, 2020 Jul.Br J Radiol. 93(1111):20200049, 2020 Jul. Review/Other-Dx 71 patients To describe the role of cross-sectional imaging findings in the management of genitourinary fistulas in pelvic malignancies. Genitourinary fistulas were observed in 71 patients (6 males, 65 females). 11 types of fistulas were identified in carcinomas of cervix, rectum, ovary, urinary bladder, sigmoid colon, vault, endometrium and prostate. The commonest were rectovaginal and vesicovaginal fistulas. 13 patients had multiple fistulas. The sensitivity, specificity, positive and negative predictive values of CT and MRI are 98%, 100%, 66%, 98% and 95%, 25%, 88% and 50% respectively. Contrast-enhanced CT with oral and rectal contrast is more sensitive and specific than MRI in the evaluation of genitourinary fistulas. 4
52. De Cecco CN, Boll DT, Bolus DN, et al. White Paper of the Society of Computed Body Tomography and Magnetic Resonance on Dual-Energy CT, Part 4: Abdominal and Pelvic Applications. J Comput Assist Tomogr. 2017 Jan;41(1):8-14. Review/Other-Dx N/A To discuss DECT for abdominal and pelvic applications and, at the end of each, will offer our consensus opinions on the current clinical utility of the application and opportunities for further research. No results stated in abstract. 4
53. Amar AD, Das S. Vesicoureteral reflux in women with primary bladder diverticulum. J Urol. 1985;134(1):33-35. Review/Other-Dx 12 patients To describe management of women with chronic UTI, vesicoureteral reflux and vesical diverticulum. Ureteral reimplantation after excision of the bladder diverticulum and repair of the bladder wall was successful in eradicating reflux in 5 patients. Bladder diverticula may perpetuate reflux and their detection is important in planning treatment. 4
54. Mermuys K, De Geeter F, Bacher K, et al. Digital tomosynthesis in the detection of urolithiasis: Diagnostic performance and dosimetry compared with digital radiography with MDCT as the reference standard. AJR Am J Roentgenol. 2010;195(1):161-167. Observational-Dx 50 patients Comparison of diagnostic performance of digital tomosynthesis and digital radiography for detection of renal calculi with NCCT used as the gold standard. Digital tomosynthesis performed better than digital radiography for detection of renal calculi but not for detection of ureteral calculi. Mean effective radiation dose was 0.5 mSv for digital radiography, 0.85 mSv for tomosynthesis, 2.5 mSv for low-dose MDCT, and 12.6 mSv for high-dose MDCT. 1
55. Pollack HM, Banner MP, Martinez LO, Hodson CJ. Diagnostic considerations in urinary bladder wall calcification. AJR Am J Roentgenol. 1981;136(4):791-797. Review/Other-Dx 19 patients Review of the causes of bladder wall calcifications with emphasis on the clinical and radiographic features. A correct diagnosis is possible by combining history, clinical examination, lab and radiograph; Cystoscopy with biopsy is almost necessary. 4
56. Boyadzhyan L, Raman SS, Raz S. Role of static and dynamic MR imaging in surgical pelvic floor dysfunction. Radiographics. 2008;28(4):949-967. Review/Other-Dx N/A To review the role of static and dynamic MRI in surgical pelvic floor dysfunction. The recent development of fast MRI sequences allows noninvasive, radiation-free, rapid, high-resolution evaluation of the entire pelvis in 1 examination. The H line, M line, organ prolapse classification system, which is applied to dynamic MRI, allows consistent standardization and grading of various forms of pelvic floor dysfunction. In addition, the H line, M line, organ prolapse system clearly defines and differentiates between the 2 main components of pelvic floor dysfunction: pelvic floor relaxation and pelvic organ prolapse. In addition to serving as an objective diagnostic tool in patients with surgical pelvic floor dysfunction, MRI has tremendous potential to be used as a research tool in trying to understand the pathophysiology of these complex disorders. 4
57. Woodfield CA, Krishnamoorthy S, Hampton BS, Brody JM. Imaging pelvic floor disorders: trend toward comprehensive MRI. AJR Am J Roentgenol. 2010;194(6):1640-1649. Review/Other-Dx N/A To review the relevant anatomy and sonographic, fluoroscopic, and MRI options for evaluating patients with pelvic floor disorders. Disorders of the pelvic floor are a heterogeneous and complex group of problems. Imaging can help elucidate the presence and extent of pelvic floor abnormalities. MRI is particularly well suited for global pelvic floor assessment including pelvic organ prolapse, defecatory function, and pelvic floor support structure integrity. 4
58. Chang YL, Lin AT, Chen KK. Presentation of female urethral diverticulum is usually not typical. Urol Int. 80(1):41-5, 2008. Review/Other-Dx 14 patients Retrospective study. A report on the authors’ experience on the diversity of presenting symptoms and signs of female urethral diverticula. Recurrent UTI, urinary incontinence, palpable suburethral mass, vaginal tenderness, and dysuria are the 5 major presenting symptoms and signs. The diagnostic rate of voiding cystourethrography during video-urodynamics, double-balloon urethrography and MRI were 10/10 (100%), 6/6 (100%) and 10/11 (90.9%) respectively. The presenting symptoms and signs of female urethral diverticula are often diverse and easily overlooked. High suspicion of this disorder, detailed history-taking and physical examination are essential for detecting urethral diverticulum in females. 4
59. Chou CP, Huang JS, Wu MT, et al. CT voiding urethrography and virtual urethroscopy: preliminary study with 16-MDCT. AJR Am J Roentgenol. 2005 Jun;184(6):1882-8. Review/Other-Dx 13 men CT voiding urethrography exams were prospectively performed with 16-MDCT to demonstrate CT voiding urethrography and CT virtual urethroscopy. The full urethral structure was clearly shown by CT voiding urethrography and virtual urethroscopy in all patients. The results of CT voiding urethrography and conventional methods correlated closely with the urethral diseases being imaged. 4
60. Chou CP, Levenson RB, Elsayes KM, et al. Imaging of female urethral diverticulum: an update. [Review] [40 refs]. Radiographics. 28(7):1917-30, 2008 Nov-Dec. Review/Other-Dx N/A Review the anatomic and pathologic features of female urethral diverticulum. Also, discuss and illustrate various diagnostic methods for evaluating female urethral diverticulum. Modern imaging techniques, including US, MRI, voiding CT urethrography, and virtual urethroscopy, can help precisely identify a female urethral diverticulum, locate its orifice, and differentiate it from other paraurethral pathologic conditions. 4
61. Foster RT, Amundsen CL, Webster GD. The utility of magnetic resonance imaging for diagnosis and surgical planning before transvaginal periurethral diverticulectomy in women. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18(3):315-319. Review/Other-Dx 27 women To report the value of magnetic resonance imaging (MRI) in the evaluation of urethral diverticulum in women. The cohort presented with a variety of symptoms. The mean time from onset of symptoms to diagnosis of a urethral diverticulum was 47 months. Seven (26%) women had a history of one or more prior diverticulectomies, and 8 (30%) had prior incontinence or other urethral surgery. Twenty-one (78%) had undergone a preoperative MRI, which detected the diverticulum in all cases. In three women, multiple other prior imaging studies had failed to identify the diverticulum despite clinical suspicion of its presence. MRI revealed an unsuspected intradiverticular carcinoma in one patient. Twenty-six women were treated with periurethral diverticulectomy, and one patient was treated with cystourethrectomy. Average follow-up was 9 (range 1-60) months. No patients had significant intraoperative complications. One patient was diagnosed (by MRI) with a recurrent diverticulum. The use of preoperative MR imaging altered the management in 15% of our patients. 4
62. Sekhar A, Eberhardt L, Lee KS. Imaging of the female urethra. Abdom Radiol (NY). 2019 Dec;44(12):3950-3961. Review/Other-Dx N/A To review the imaging features of common benign and malignant conditions of the female urethra including diverticula, benign cystic and solid lesions, malignancy, surgical slings, and injection of bulking agents. No results stated in abstract. 4
63. Mahfouz W, Hassan HHM, Gubbiotti M, Elbadry M, Moussa A. Does a tailored magnetic resonance imaging technique affect the surgical planning and outcomes for different cystic urethral and periurethral swellings in females? Seven years tertiary center experience. World J Urol. 2022 Jun;40(6):1587-1594. Review/Other-Dx 57 patients To evaluate the use of magnetic resonance imaging (MRI) in preoperative delineation and surgical planning for the management of female urethral and periurethral cystic vaginal swellings, with emphasis on postoperative surgical outcomes. Urethral diverticulum was the commonest cystic lesion representing (64.9%) followed by Skene gland cysts in 14%, Mullerian cysts in 7%, Gartner cysts in 3.5%, and dermoid inclusion cysts in 10.5%. MRI precisely diagnosed the various pathological entities and anatomical complex lesions prior to surgery. This was confirmed after surgery and pathology analysis. All patients were followed up with a mean duration of 35 months, without any evidence of recurrence. 4
64. Chulroek T, Wangcharoenrung D, Cattapan K, et al. Can magnetic resonance imaging differentiate among transurethral bulking agent, urethral diverticulum, and periurethral cyst?. Abdom Radiol (NY). 2019 Aug;44(8):2852-2863. Review/Other-Dx 50 patients To evaluate magnetic resonance imaging findings that differentiate among periurethral bulking agents (primarily collagen), urethral diverticulum, and periurethral cyst. Magnetic resonance imaging features found more often in bulking agents versus urethral diverticulum were multiple lesions (P = 0.011), upper or upper-mid-urethral location (P = 0.0001), lack of internal fluid/fluid level (P = 0.002), no urethral connection (P = 0.005), T1 isointensity, and T2 mild hyperintensity compared to muscles but lower T2 signal than urine (P < 0.0001). Most cases of urethral diverticula and periurethral cysts were detected at mid- and lower urethra. Urethral diverticula were larger than bulking agents and periurethral cysts (P = 0.005 and P = 0.023) (mean diameter = 24, 16, 15 mm, respectively). Most bulking agents (93%) and urethral diverticula (90%) showed mass effect on urethra, while periurethral cysts (75%) did not (P < 0.0001). 4
65. Cruz J, Figueiredo F, Matos AP, Duarte S, Guerra A, Ramalho M. Infectious and Inflammatory Diseases of the Urinary Tract: Role of MR Imaging. Magn Reson Imaging Clin N Am. 2019 Feb;27(1):S1064-9689(18)30068-0. Review/Other-Dx N/A The role of MR imaging for the evaluation of infectious and inflammatory disease processes of the urinary tract is reviewed. No results stated in abstract. 4
66. Ravichandran S, Ahmed HU, Matanhelia SS, Dobson M. Is there a role for magnetic resonance imaging in diagnosing colovesical fistulas?. Urology. 72(4):832-7, 2008 Oct.Urology. 72(4):832-7, 2008 Oct. Review/Other-Dx 22 patients To assess the role of MRI in the investigation of patients with probable colovesical fistulas. MRI correctly identified the presence of a fistula and defined the underlying etiology in 18/19 patients. Colovesical fistula was correctly excluded in 1 of 19 patients. The remaining 3 patients were either unfit for surgery or refused. 4
67. Tang YZ, Booth TC, Swallow D, et al. Imaging features of colovesical fistulae on MRI. Br J Radiol. 2012;85(1018):1371-1375. Review/Other-Dx 40 cases To quantify the MRI characteristics of these fistulae. There were 40 cases of colovesical fistulae. On MRI, the fistula morphology consistently fell into 3 patterns. The most common pattern (71%) demonstrated an intervening abscess between the bowel wall and bladder wall. The second pattern (15%) had a visible track between the affected bowel and bladder. The third pattern (13%) was a complete loss of fat plane between the affected bladder and bowel wall. MRI correctly determined the underlying aetiology in 63% of cases. 4
68. Morey AF, Brandes S, Dugi DD 3rd, et al. Urotrauma: AUA guideline. Journal of Urology. 192(2):327-35, 2014 Aug.J Urol. 192(2):327-35, 2014 Aug. Review/Other-Dx N/A To review the urologic trauma literature to guide clinicians in the appropriate methods of evaluation and management of genitourinary injuries. Guideline statements were created to inform clinicians on the initial observation, evaluation and subsequent management of renal, ureteral, bladder, urethral and genital traumatic injuries. 4
69. ACOG Practice Bulletin No. 101: Ultrasonography in pregnancy. Obstet Gynecol. 2009 Feb;113(2 Pt 1):451-61. Review/Other-Dx N/A Ultrasonography in pregnancy. No abstract available. 4
70. American College of Radiology. ACR Committee on Drugs and Contrast Media. Manual on Contrast Media.  Available at: https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Contrast-Manual. Review/Other-Dx N/A Guidance document to assist radiologists in recognizing and managing the small but real risks inherent in the use of contrast media. No abstract available. 4
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