Benign Prostate Diseases - A Review

Congress:

ECR 2020

Poster Number:

C-15231

Type:

Educational Exhibit

Keywords:

Not applicable, Neoplasia, Hyperplasia / Hypertrophy, Cysts, Diagnostic procedure, Ultrasound, MR, CT, Urinary Tract / Bladder, Genital / Reproductive system male, Abdomen, Genitourinary, Performed at one institution

Authors:

E. Pacheco¹, M. P. F. Ananias¹, C. T. S. GUIMARAES², R. F. T. Romano¹, L. J. Sauer¹, L. Bittencourt³; ¹São Paulo/BR, ²SAN FRANCISCO, CA/BR, ³Rio de Janeiro/BR

DOI:

10.26044/ecr2020/C-15231

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-15231

Fig. 7: Manual planimetry. Sagittal T2WI reconstruction (A) and axial T2WI image (B),...

Fig. 8: IPP. Sagittal T2WI image demonstrate how to measure IPP (arrow).

Fig. 9: PUA. Sagittal T2WI of a normal prostate (A) and hyperplastic enlarged prostate...

Table 1: Utricle vs Mullerian Cysts.

Learning objectives

To identify non-malignant conditions that affect the prostate. To recognize prostate zonal anatomy and age-related changes. To discuss MRI findings of benign prostatic diseases.

Background

There has been a substantial spread of multiparametric magnetic resonance imaging(mpMRI) for prostate cancer management (PCa). Consequently, prostatic benign conditions become more encountered, including benign prostatic hyperplasia (BPH), prostatitis, benign tumors, and congenital anomalies. The prostate is divided into four glandular zones: peripheral zone (PZ), central zone (CZ), transition zone (TZ), periurethral glands (PUGs), and one stromal zone, the anterior fibromuscular stroma (AFMS) (Fig. 1). T2-weighted MRI (T2WI) provides the best tissue contrast to delineate zonal anatomy. 1.Benign prostatic hyperplasia It's a histologic diagnosis, referring...

Findings and procedure details

1.Benign prostatic hyperplasia 1.1.Pathophysiology and imaging correlation Involves the TZ and PUGs (Fig. 2), comprising both glandular (T2WI high signal) and stromal (T2WI low signal) enlargements [5] (Fig. 3). Two mechanisms proposed to LUTS, but most commonly both coexist: Static effect: increased bulk from epithelial hyperplasia causing bladder outlet obstruction (BOO); Dynamic effect: stromal hyperplasia resulting in increased muscle tone around the urethra [6]. Moreover, the distortion of urethra causes more obstruction than compression. Therefore, the hyperplasia site rather than size may be the dominant...

Conclusion

Several symptomatic and asymptomatic benign conditions may clinically simulate PCa in the course of general screening, or may pose as incidental findings on pelvic studies. In this context, benign conditions should be well recognized and accordingly included in the differential diagnoses.

Personal information and conflict of interest

E. Pacheco; São Paulo/BR - nothing to disclose C. T. S. Guimaraes; SAN FRANCISCO, CA/BR - nothing to disclose L. Bittencourt; Rio de Janeiro/BR - nothing to disclose R. F. T. Romano; São Paulo/BR - nothing to disclose L. Sauer; São Paulo/BR - nothing to disclose M. P. Ferri; São Paulo/BR - nothing to disclose

References

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