|Case 13 :|
male with difficulty in micturition. Following lab and ultrasound tests,
an MRI scan was performed.
What is the diagnosis?
|__________SCROLL FOR ANSWER__________|
Axial t1w image shows capsular bulge in the right posterior aspect involving the neurovascular bundle, with T2WI axial showing a hypointense area in the peripheral zone on the right side suggestive of malignancy. Image 3 axial stir shows the same finding of a hypointense area in the peripheral zone
the prostate (ACP) is an exceedingly common malignancy. In 1990
Stage A: tumors that
are discovered incidentally on histollogic
Stage B: tumors are
palpable on rectal examination and are confined
Stage C: tumors which
have penetrated the peripheral capsule of the
Stage D: tumors which
have spread to the pelvic lymph nodes and have
MR Spectroscopy and the Prostate
Proton, phophorus and carbon MRS have been used in studies both in vitro and in vivo, to associate levels of metabolites with benign or malignant prostate lessions. The levels of phosphocreatine (PCr) and phosphomonesters (PME) can be used to distinguish malignant from benign tissue.
Carcinoma of the prostate is best demonstrated on T2 weighted images, showing a loss of bright signal of both the peripheral zone and seminal vesicles. T1 images are valuable for depicting extra-capsular spread, bone metastases, and lymphadenopathy. Invention of multi-planar fast spin echo seguences had improved the examination of the prostate in four ways: examination is faster, more planes can be covered, TE can be increased to achieve more T2 weighting, phase encodings can be increased to increase resolution, and decreased acquisition time per series reduces motion artifacts
Fat-suppression techniques have been reported to improve the detection of capsular penetration by ACP
Dr. Ashok Raghavan, Manipal Hospital, Bangalore