Chou et al [19] described the results of CT voiding urethrography using 16-multidetector CT in 13 men and found a high correlation between the results of conventional RUG and CT voiding urethrography for evaluating traumatic and nontraumatic urethral conditions. Findings of penetrating urethral trauma on CT voiding urethrography include extravasation of contrast media, irregularity of the urethral lumen, and hematomas. CT Pelvis Pelvic CT without IV contrast provides limited evaluation for suspected penetrating injury to the lower urinary tract because of nonopacification of the urinary bladder lumen and lack of enhancement of the pelvic viscera [18]. However, it may be useful in detecting fluid or hematoma adjacent to the urinary bladder, prompting a follow-up evaluation with radiographic or CT cystography. Pelvic CT without IV contrast may be occasionally considered for evaluation of urethral or periurethral foreign body. Pelvic CT with IV contrast allows improved assessment of the pelvic viscera and vessels compared with CT without IV contrast. However, evaluation for bladder injury remains limited because of suboptimal distension and nonopacification of the urinary bladder lumen. The use of antegrade cystography, during which the urinary bladder is gradually opacified by excretion of IV contrast, provides inadequate evaluation of bladder injury that is due to suboptimal distension of the bladder lumen, dilution of excreted contrast material by urine, and the time delay required for excretion of IV contrast [2]. Pelvic CT without and with IV contrast is suboptimal compared with CT cystography because of the reasons described in the previous 2 paragraphs. Specifically, pelvic CT without and with IV contrast does not provide MRI Pelvis There is no relevant literature regarding the use of MRI in the evaluation of penetrating trauma to the lower urinary tract.
Penetrating Trauma Lower Abdomen and Pelvis. Chou et al [19] described the results of CT voiding urethrography using 16-multidetector CT in 13 men and found a high correlation between the results of conventional RUG and CT voiding urethrography for evaluating traumatic and nontraumatic urethral conditions. Findings of penetrating urethral trauma on CT voiding urethrography include extravasation of contrast media, irregularity of the urethral lumen, and hematomas. CT Pelvis Pelvic CT without IV contrast provides limited evaluation for suspected penetrating injury to the lower urinary tract because of nonopacification of the urinary bladder lumen and lack of enhancement of the pelvic viscera [18]. However, it may be useful in detecting fluid or hematoma adjacent to the urinary bladder, prompting a follow-up evaluation with radiographic or CT cystography. Pelvic CT without IV contrast may be occasionally considered for evaluation of urethral or periurethral foreign body. Pelvic CT with IV contrast allows improved assessment of the pelvic viscera and vessels compared with CT without IV contrast. However, evaluation for bladder injury remains limited because of suboptimal distension and nonopacification of the urinary bladder lumen. The use of antegrade cystography, during which the urinary bladder is gradually opacified by excretion of IV contrast, provides inadequate evaluation of bladder injury that is due to suboptimal distension of the bladder lumen, dilution of excreted contrast material by urine, and the time delay required for excretion of IV contrast [2]. Pelvic CT without and with IV contrast is suboptimal compared with CT cystography because of the reasons described in the previous 2 paragraphs. Specifically, pelvic CT without and with IV contrast does not provide MRI Pelvis There is no relevant literature regarding the use of MRI in the evaluation of penetrating trauma to the lower urinary tract.