Multiparametric MR Urethrography: Dynamic Comprehensive Evaluation of the Male Urethra

Urethral diseases in males, such as strictures, traumarelated injuries, and neoplasms, are significant clinical challenges that can greatly impact urinary function and quality of life. The complex anatomy of the male urethra, which traverses structures such as the prostate and corpus spongiosum, make it particularly susceptible to injuries and strictures compared with the female urethra. The clinical assessment of urethral abnormalities is often limited, necessitating the use of imaging studies for thorough evaluation. While traditional radiographic techniques such as retrograde urethrography and voiding cystourethrography enable visualization of the urethral lumen, they have limitations in the assessment of periurethral tissues. MR urethrography (MRU) has emerged as a noninvasive modality that offers detailed anatomic insights into the urethra and periurethral structures. The authors review the embryologic features and anatomy of the male urethra and the risk factors associated with male urethral diseases. In addition, helpful imaging methods are discussed, with specific emphasis on MRI as a comprehensive modality and on optimal techniques for MRU protocols. A range of urethral diseases are described and illustrated, and key points for reporting MRU findings are highlighted. ^©RSNA, 2025 Supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article.