Evaluation of the female bladder neck and urethra using MRI with fiber tractography: Prospective study on a large cohort of continent women. Issue 6 (26th May 2021)

• Record Type: Journal Article
• Authors: Roy, Catherine; Ohana, Mickael; Labani, Aissam; Tricard, Thibault; Saussine, Christian; Leyendecker, Pierre
• Is Part Of: Neurourology and urodynamics. Volume 40:Issue 6(2021)
• Page Start: 1441
• Page End: 1449
• Publication Date: 2021-05-26
• Subjects: diffusion tensor imaging (DTI) -- female urethra -- fiber tractography -- magnetic resonance imaging (MRI); Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.24674
• Languages: English
• ISSNs: 0733-2467

Abstract

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.