Tae-Hyung Kim1, Sang Youn Kim1,2, Kyung Chul Moon3, Joongyub Lee4, Jeong Yeon Cho1,2, Seung Hyup Kim1,2. 1. 1 Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Korea. 2. 2 Seoul National University College of Medicine, Seoul, Korea. 3. 3 Department of Pathology, Seoul National University Hospital, Seoul, Korea. 4. 4 Medical Research Collaborating Center, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea.
Abstract
OBJECTIVE: The purpose of this study is to evaluate the MRI findings differentiating clear cell adenocarcinoma of the urethra (CCAU) from nonadenocarcinoma of the urethra (NACU) and non-clear cell adenocarcinoma of the urethra (NCCAU) in women. MATERIALS AND METHODS: Six women with pathologically proven CCAU, six women with pathologically confirmed NACU (two squamous cell carcinomas and four transitional cell carcinomas), and nine women with NCCAU underwent preoperative MRI. The MRI findings for CCAU, NACU, and NCCAU were reviewed by a radiologist who was blinded to the histopathologic findings and were compared using the Mann-Whitney U test and the Fisher exact test. RESULTS: CCAU was shorter in height than NACU (3.4 cm vs 5.5 cm; p = 0.020) and also had a smaller height-to-width ratio than NACU (0.85 vs 1.51; p < 0.001) and NCCAU (0.85 vs 1.48; p = 0.002). The proportion of preserved urethra in CCAU (67%) was larger than that in either NACU (9%; p < 0.001) or NCCAU (22%; p < 0.001). All cases of CCAU originated within a diverticulum, whereas none of the cases of NACU and only one NCCAU originated in a diverticulum. Intratumoral septation was more frequently observed in CCAU (100%) than in NACU (16.6%; p = 0.015) or NCCAU (11.1%; p = 0.001). CONCLUSION: MRI findings for CCAU were significantly distinctive, compared with findings for NACU and NCCAU. All cases of CCAU were associated with a urethral diverticulum, and CCAU had a lower height-to-width ratio, more frequent intratumoral septation, and greater preservation of normal urethra than did NACU and NCCAU.
OBJECTIVE: The purpose of this study is to evaluate the MRI findings differentiating clear cell adenocarcinoma of the urethra (CCAU) from nonadenocarcinoma of the urethra (NACU) and non-clear cell adenocarcinoma of the urethra (NCCAU) in women. MATERIALS AND METHODS: Six women with pathologically proven CCAU, six women with pathologically confirmed NACU (two squamous cell carcinomas and four transitional cell carcinomas), and nine women with NCCAU underwent preoperative MRI. The MRI findings for CCAU, NACU, and NCCAU were reviewed by a radiologist who was blinded to the histopathologic findings and were compared using the Mann-Whitney U test and the Fisher exact test. RESULTS: CCAU was shorter in height than NACU (3.4 cm vs 5.5 cm; p = 0.020) and also had a smaller height-to-width ratio than NACU (0.85 vs 1.51; p < 0.001) and NCCAU (0.85 vs 1.48; p = 0.002). The proportion of preserved urethra in CCAU (67%) was larger than that in either NACU (9%; p < 0.001) or NCCAU (22%; p < 0.001). All cases of CCAU originated within a diverticulum, whereas none of the cases of NACU and only one NCCAU originated in a diverticulum. Intratumoral septation was more frequently observed in CCAU (100%) than in NACU (16.6%; p = 0.015) or NCCAU (11.1%; p = 0.001). CONCLUSION: MRI findings for CCAU were significantly distinctive, compared with findings for NACU and NCCAU. All cases of CCAU were associated with a urethral diverticulum, and CCAU had a lower height-to-width ratio, more frequent intratumoral septation, and greater preservation of normal urethra than did NACU and NCCAU.