The magnetic resonance imaging appearances of the interureteric crest of the urinary bladder
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ORIGINAL ARTICLE
The magnetic resonance imaging appearances of the interureteric crest of the urinary bladder Peter Abernethy1 · Petra Williams2 · Simon Freeman2 Received: 4 February 2020 / Accepted: 9 May 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Purpose This study was devised to evaluate the imaging appearances of the interureteric crest (IUC) of the bladder on magnetic resonance imaging (MRI). The primary objective was to determine how commonly the IUC was observed on pelvic MRI examinations. The secondary objectives were to determine the average size of the IUC, its MRI signal characteristics and whether there is variation between men and women. By defining the imaging findings we hope to prevent misinterpretation of normal anatomy on MRI and, therefore, prevent unnecessary further investigations and procedures. Methods We retrospectively reviewed 114 adult patient’s magnetic resonance imaging examinations of the pelvis. Two readers independently recorded information about the presence and characteristics of the IUC with a third reader used to arbitrate in cases of disagreement. Results The IUC was demonstrated on MRI in 75% of patients. It was best observed on T2w sequences as a continual ridge of low signal intensity between the ureters. The mean AP diameter of the IUC at its mid-point on the sagittal images was 2.4 mm. Conclusions The IUC is often seen on MRI on T2w images of a non-collapsed bladder. Its characteristic appearance can be used to help the reporting radiologist confidently differentiate identify this normal structure from an area of focal bladder wall thickening that might be misinterpreted as a bladder tumor. Keywords Interureteric crest · Interureteric ridge · Urinary bladder · Magnetic resonance imaging · Urinary bladder neoplas
Introduction The urethral orifices of the urinary bladder are separated by a gently curved bundle of non-striated muscle, the torus uretericus. This muscle bundle extends slightly lateral to each ureteric orifice, this lateral extension is named the plica uretericae. Commonly both the torus uretericus and plica uretericae are collectively referred to as the interureteric ridge or interureteric crest (IUC) [1]. There is very little information regarding the imaging appearance of the IUC in the radiological literature. Abnormality of the IUC has been described on intravenous * Peter Abernethy [email protected] 1
Peninsula Radiology Academy, William Prance Road, Plymouth PL6 5WR, UK
University Hospitals Plymouth NHS Trust, Derriford Road, Crownhill, Plymouth PL6 8DH, UK
2
urography (IVU) with reports demonstrating oedema of the IUC in 26% of patients with distal ureter obstruction due to renal calculi [1, 2]. It has also been proposed that asymmetry of the IUC on an IVU, without acute symptoms, should suggest the presence of a bladder cancer [1]. With the widespread application of cross-sectional imaging techniques these secondary signs on IVU are of less relevance in modern radiology practice and symptoms suggestive
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