Cystic lesions of the female lower GU tract are common incidental findings that may have an inflammatory, infectious or congenital cause.

Due to the short length of the female urethra and its complex surroundings, its diagnosis is often challenging. Nevertheless, they tend to arise in specific anatomic locations and have distinguishing imaging features that help narrow the diagnosis.

Magnetic resonance (MR) has become the preferred imaging technique in cases of non-specific pelvic and lower urinary symptoms. The key advantages of using MR imaging in these cases include its noninvasive nature, its ability to perform multiplanar imaging, its optimal soft tissue differentiation, and good contrast resolution.

These lesions usually demonstrate signal intensity like those of fluid and can best be seen on T2-weighted sequences as hyperintense lesions. 

However, in the presence of complications, such as hemorrhage, infection or malignant transformation, there may exist enhancing components (peripheral or nodular/mass-like enhancements) and variations in signal intensity.