MRI PROSTATE (Plain and contrast)

Multiplanar multiecho sequences of the pelvis were performed on a 3.0 Tesla Philips
Ingenia scanner with high resolution imaging of the prostate. Dynamic post contrast
perfusion study was done with MR spectroscopy.
Hx: Biopsy proven case of carcinoma prostate for local staging.
FINDINGS:Prostate measure ~ 41 x 40 x 36 mm in max Trans x AP x CC dimensions (~ 26 cc in volume) is
mildly bulky in size. The central gland shows mild hypertrophy with the median lobe projecting
into the urinary bladder base.
A large ill defined T2 hypointense region measuring ~ 27 x 21 mm in size is noted involving the
peripheral zone posteriorly on the right side. This nodular lesion shows hypoperfusion with
evidence of restricted diffusion and abuts the prostatic - seminal vesicle interface with
unremarkable bilateral seminal vesicles. Evidence of focal capsular bulge / obvious capsular
breach posterosuperiorly with small focal region of illdefined fat planes with the bladder base.
Neurovascular structures appear unremarkable.
MR spectroscopy over this nodular lesion shows significant elevation of choline.
Multiple small bilateral iliac lymphnodes are seen showing restricted diffusion with the largest
measuring 22 x 15 mm in size on the right side.
Urinary bladder is minimally distended with mild diffuse wall thickening.
Rectoprostatic planes are intact.
Rectosigmoid and ischiorectal fat appears unremarkable.
The visualised bones of the pelvis and the lumbar vertebrae do not show obvious evidence of
skeletal lesions.
IMPRESSION: Mild prostatomegaly with a large ill defined T2 hypointense nodular lesion involving the
peripheral zone posteriorly on the right side with loss of zonal differentiation. This
nodular lesion shows hypoperfusion with evidence of restricted diffusion and abuts the
prostatic - seminal vesicle interface with unremarkable bilateral seminal vesicles.
Evidence of focal capsular bulge / obvious capsular breach posterosuperiorly with small
focal region of illdefined fat planes with the bladder base. Neurovascular structures
appear unremarkable.

 The visualised bones of the pelvis and the lumbar vertebrae do not show obvious
evidence of skeletal lesions.
Multiple small bilateral iliac lymphnodes are seen showing restricted diffusion with the
largest measuring 22 x 15 mm in size on the right side.
-

MRI findings are consistent with neoplastic etiology with locally aggressive disease
(capsular breach with possible focal infiltration of the trigone of urinary bladder on
right side).

For clinical correlation / follow up.

DR.CHAITANYA PURANIK
Sr. Consultant Radiologist

DR.PIYUSH SAXENA
Consultant Radiologist