Magnetic resonance imaging in assessment of stress urinary incontinence in women: Parameters differentiating urethral hypermobility and intrinsic sphincter deficiency

Figure 1 41-year-old woman post one vaginal delivery with episiotomy, body mass index: 46. 7, with occasional stress urinary incontinence. A: Axial T2-weighted image of the mid urethra obtained with 14F endourethral MR coil (TR/TE 4816/68 ms) shows detailed depiction of the urethral sphincter with a hypointense outer layer of striated muscle (arrow) and inner hyperintense smooth muscle layer (arrowhead); B: Axial T2-weighted image at the mid urethra level obtained with endovaginal placement of MRInnervu coil (EV) (TR/TE 3000/92 ms) shows well-defined intact periurethral ligament (arrow) extending between the right and left puborectalis muscle (black arrowheads). Note symmetric, intact ligament attachment (white arrowheads); C: Sagittal T2-weighted image obtained with endovaginal placement of MRInnervu coil (EV) (TR/TE 4000/92 ms) shows normal resting position of the urethra, with distal end of urethral sphincter (arrow) at inferior pubis level (P). Note excellent coaptation of the mucosa at internal meatus/bladder neck level (arrowhead). V: Vagina.