What is an MRI of the prostate done for

MRI diagnostics of the prostate gland: what does the study of the prostate with and without contrast shows?

Prostate MRI creates a visualized computer model of the anatomy of the organ, which allows you to determine the volume, structure and location of all pathological changes in the gland, as well as the degree of involvement in the spread of the disease of neighboring tissues. This is a harmless and highly informative technology of modern medicine. It differs from CT in safety and more accurate results.

Diagnosis of prostate diseases using MRI

The use of magnetic resonance imaging provides high accuracy and allows you to detect the following diseases:

Prostatitis is an inflammation of the prostate gland in acute and chronic forms, as well as in the abscess phase with a layer of pus. Hyperplasia (adenoma) - proliferation of connective tissues, resulting in compression of the urethra. The disease is dangerous with serious complications. Early detection is the key to effective treatment. Crayfish. The problem of curability consists in diagnosing the disease in the first phase. At the beginning, the disease has no specific symptoms. The study of the prostate using MRI provides the most qualitative and reliable data on the presence of cancer, its stage and localization. The organ under study is small and deeply immersed in the body. In this regard, classical magnetic exposure is not enough for high-quality diagnostics. In this case, additionally assigned:

• MR spectroscopy. The result of the study is the chemical composition of the gland.
• MR diffusion/perfusion that separates normal and diseased tissues.

Types of MRI examination of the prostate:

Classic study without the introduction of contrast markers and probe. Within 30-40 minutes, the desired area of the body is scanned. With contrast. Before the procedure, the patient is injected with a substance, its traces are clearly visible on the screen. Blood carries the drug to all tissues, including the tumor. Contrast does not harm, it only helps to better see the boundaries of the disease. With endorectal coil. A thin flexible wire covered with an elastic braid is inserted into the rectum. It creates an additional magnetic field in the desired area, which makes the image more distinct. Multiparamatic MRI is a combination of all types of magnetic tomography. Magnetic resonance imaging, including the prostate gland, has a high reliability of results, higher than that of other diagnostic methods. In addition to this advantage, unlike a CT scan of the prostate, it does not expose the patient to the harmful effects of x-rays. The exception is people who have contraindications for MRI. For them, a CT scan of the prostate is provided.

Advantages of magnetic resonance imaging methods:

• safety - the technology does not involve the use of ionizing radiation and non-invasive intervention;
• high level of detail and accuracy of results;
• the ability to obtain not only an image and determine the structure of an organ, but also to conduct its chemical analysis;
• Speed of examination - the procedure lasts 30-40 minutes.

Preparation for tomography

To perform a high-quality examination, patient preparation is necessary, namely:

• Prepare documents for the doctor - referral, conclusions about previous studies.
• During the day before the procedure, limit the use of foods that cause increased gas formation - cabbage, legumes, fruits, milk, black bread. Espumizan should be taken to avoid flatulence.
• Empty your bowels. If necessary, give an enema.
• Stop eating 4 hours before diagnosis.
• 2 hours before the procedure, drink water to fill the bladder.
• Half an hour before the examination, take an antispasmodic (No-shpa, Spazmalgon, others).
• If the patient is anxious, a mild sedative may be used.

Steps of the procedure

The magnetic resonance tomograph is a complex device consisting of a retractable table and a cylindrical tunnel surrounded by a magnet. For patients with claustrophobia or weighing more than 130 kg, models of devices with open side walls are provided. An MRI examination of the prostate is carried out as follows:

The patient must change in the locker room and deposit valuables, watches, electronic devices. The doctor injects a gadolinium-based contrast agent into the vein, if contrast was provided. During a dynamic study, a dropper with a saline solution is placed in the patient, into which a marker is added after the start of the scan. If it is intended to use an endorectal coil, then the specialist prepares it as follows.A special cuff is smeared with petroleum jelly or gel. The sensor is placed in it. The cuff is inserted into the rectum and then inflated. At the end of the procedure, it is deflated and removed from the patient's body. The patient lies on a sliding table on his back. Puts on headphones or puts earplugs in the ears. Inside the tomograph there is a voice communication for communication with the staff. The specialist instructs the patient about the upcoming procedure and the rules of conduct during it, including the obligation to maintain complete immobility. Scanning lasts 30-40 minutes. If necessary, the session can last as long as necessary to obtain a quality result. The specialist deciphers the images and sends it to the treating doctor. Contrasting for more precision

The injected substance is instantly carried by the blood through the internal organs, reaching the prostate and tumors. On the computer screen, the boundaries of the prostate and tumors are clearly visible. You can accurately find out the geometric parameters, the structure of not only the tumor, but also the smallest metastases.

When using contrast, Side effects may occur in the form of fever, third-party taste in the mouth, rapid breathing and palpitations. Such manifestations should be reported to the doctor immediately. To do this, the device provides voice communication.

MRI for prostate cancer

Prostate cancer often affects older men. The disease first manifests itself in difficulty urinating, incomplete outpouring of the contents of the bladder. Then there is intoxication, weakness, depression. Already when such signs appear, you should contact a urologist and undergo an MRI of the prostate gland.

The most important advantage of endorectal MRI in diagnosing pancreatic cancer is the accurate visualization and localization of the size, nature and location of the tumor. The sources of information are foci of low signal intensity in the peripheral region of the prostate. Irregular, uneven contours, diffuse spread are signs of a malignant disease.

Advantages of multiparametric MRI

Multiparametric MRI is a combined study, where all methods of magnetic resonance diagnostics are involved. This procedure gives the most accurate result known. With this integrated approach, it is possible to evaluate the following:

• with dynamic contrasting, the work of blood vessels in the prostate and neighboring organs is analyzed;
• diffusion-weighted tomography shows the parameters of water exchange in the studied tissues;
• MRI spectroscopy determines the level of concentration of various substances in the prostate gland;
• 3D modeling creates an overall picture and eliminates misinterpretation of the various parameter values obtained during the survey.

The use of such an integrated approach to the diagnosis of pathologies is especially effective when combined with a biopsy. This allows you to identify the most aggressive areas of the cancerous tumor. The advantage is that a conventional biopsy is performed at random with multiple punctures. With multiparametric MRI, the doctor knows the location of the neoplasm and takes point samples under the simultaneous control of the ultrasound machine and the tomograph, which minimizes errors in the penetration of the needle into the body of the tumor.

When is CT diagnostics indicated?

There are patients for whom MRI is contraindicated. For them, CT and other diagnostics of the prostate gland are prescribed, despite the fact that this is a less accurate method, because the tissue of the examined organ contains many liquid components and is surrounded by bone structures. The procedure can be applied to the category of patients who:

• allergic to contrast agents;
• pacemakers;
• metal implants;
• insulin pumps;
• surgical clips in vessels and tissues;
• hearing aid in the middle ear;
• claustrophobia;
• weight over 130 kg.

CT of the affected prostate cancer is performed in the following cases:

• in order to determine the degree of damage by a cancerous tumor to neighboring tissues with a high risk of spread, calculated according to the Glisson scale;
• to detect regional screenings in the pelvic lymph nodes;
• for accurate planning of surgery and radiotherapy;
• to clarify an already diagnosed diagnosis.

When the patient's condition is severe, the procedure is performed to distinguish between acute parenchymal prostatitis and prostate abscess.The CT examination is carried out as follows:

• the doctor examines the patient, fixes his condition, finds out if there are any allergies to contrasts, chronic diseases;
• the patient lies on the couch of the tomograph, a catheter is inserted into the vein to inject a contrast marker;
• the catheter is connected to the injector;
• scanning is carried out, sometimes several times in different phases of contrast absorption;
• The results are interpreted by a specialist and transferred to the attending physician.

Indications for MRI examination of the prostate preparation, contraindications and cost

Today, MRI of the prostate is the most informative method for examining prostate tissue. Magnetic resonance imaging helps to accurately determine the presence of pathology in the organ, determine its specificity, chemical composition, development dynamics. The procedure is safe and painless for the patient. This method of diagnosis contributes to obtaining clear images, but based on reading which, the doctor will be able to prescribe the correct treatment.

What is prostate MRI

The study of the prostate by magnetic resonance imaging is based on the reaction to the interaction of tissue structures of the human body with a magnetic field. In this way, you can check the condition of the prostate gland and adjacent organs (lymph nodes, bladder, rectum). The results reflected in the images help to objectively assess organic changes in tissues, establish the type of pathologies, their prevalence. If a person is healthy, the device will reflect the absence of signs of illness.

MRI of the prostate with contrast

The method of conducting an MRI examination of the prostate with contrast involves the introduction of a special substance into the patient's blood, which is well distinguished by the device. This type of diagnosis is prescribed by a doctor in most cases with suspected Prostate cancer. A contrast agent is injected through the patient's vein just before the start of the procedure. Before choosing an MRI with contrast, the doctor sends the person for an analysis, which should establish his sensitivity to the substance.

MRI without contrast

Magnetic resonance imaging of the prostate without contrast can be performed in 2 ways:

• Classic - this method does not provide for additional procedures, except for preparation and direct research. A person is placed on a movable table, which is immersed in a capsule with magnets installed in it.
• With an endorectal coil - in this case, a special flexible wire is inserted into the patient's rectum. Such a device creates an additional magnetic field located in close proximity to the prostate. The examination mechanism with the endorectal coil contributes to a more accurate diagnosis.

What is an MRI of the prostate done for

Prostate MRI is used to confirm or deny the presence of certain diseases:

• oncological diseases of the genital organs;
• prostatitis;
• venereal diseases;
• viral and fungal infections;
• prostate adenomas;
• diphallia, cryptorchidism - congenital pathologies of the prostate gland;
• complications after surgical operations.

For prostatitis

In men, such a disease develops due to the action of pathogenic microflora or microcirculation disorders in the prostate gland with venous insufficiency. Congestion and prolonged inflammation provoke a decrease in local immunity. If prostatitis is not detected in time, it can cause the development of an abscess. Treatment of this complication is reduced to surgical intervention. To accurately determine the disease and its stage, doctors recommend that the patient, if prostatitis is suspected, undergo an MRI using a contrast agent.

For prostate cancer

Malignant tumors of the prostate are often found in older men. The first alarming signs are manifested in problems with urination, incomplete emptying of the bladder. As the formation increases, there are signs of intoxication, increased fatigue, depression, irritability and general weakness. When a patient has these symptoms, indicating the possible development of a tumor in the prostate gland, the urologist prescribes an MRI to examine in detail the presence, size and type of tumor in the prostate.

For prostate adenoma

With an increase in the intensity of the synthesis of prostate cells, adenoma or prostate hyperplasia may occur. The growth of tissues provokes difficulty in urination, sexual dysfunction, urinary incontinence and the formation of constipation. In the early stages, adenoma is often asymptomatic, detected by ultrasound.Doctors prescribe an MRI of the prostate to confirm or refute the presence of a diagnosis, to determine the degree of tissue growth. Based on the study, a treatment plan is formed.

Preparing for MRI of the prostate

In order for the procedure to show the most accurate result, important conditions must be met. Specialists distinguish the following stages of preparation for MRI of the prostate:

• The patient is shown a diet that should eliminate the possibility of formation of gases in the digestive tract. To do this, before the MRI procedure, it is strictly forbidden to eat cabbage, fresh pastries, beans, cereals, carrots, sour-milk and carbonated drinks. This diet should last 3 days.
• You can get unreliable results if there is excess fluid in the body, so the last drink should be made no later than 6 hours before the start of the study.
• If the MRI is done with a coil inserted, the patient can be given pain medication by injection within half an hour if necessary.
• When gas and bloating are detected in a patient, the patient is given an active sorbent that eliminates symptoms.
• Before starting the MRI procedure, you need to remove all metal objects from yourself, as they provoke image distortion.
• The bladder should be moderately full, so urination should be done 2 hours before the MRI.

MRI examination of the prostate

Today, MRI is the most accurate method for diagnosing prostate pathologies. Experts highlight the objective advantages of tomography:

• during the study, the human body is not exposed to ionizing radiation;
• compared to computed tomography, images of soft tissues are more accurate and clear;
• due to the reaction of the device to diffuse changes in tissues and cells, it is possible to recognize the disease at an early stage;
• MRI accurately determines the properties of benign and malignant tumors, establishes the dynamics of their development.

For all the safety of the procedure, there are contraindications to its implementation:

• an allergic reaction to the substances that make up the staining preparation in the contrast method;
• presence of fibrosis;
• diseases of the adrenal glands and kidneys;
• Excessive weight can be an obstacle to conducting research inside a closed device.

How it is done

The procedure for MRI examination of the prostate area is as follows:

• Depending on the type of MRI, a special staining agent is injected into the patient intravenously or a rectal probe is injected into the rectum.
• To make a high-quality MRI, the patient is placed motionless on the surface of the apparatus, if necessary, special holding devices are used. Then the patient either gets inside the capsule of the device, or a large magnet is placed above it.
• The MRI procedure takes about half an hour, if contrast is used, the time is doubled. The patient must remain still in order for the images to be clear.
• The doctor monitors the progress of the study and the state of the person using audio and video communication.
• Such a study is painless and safe. The body may respond to the action of the magnetic field by the appearance of a feeling of warmth in the area of monitoring.

MRI interpretation

The reading of the results of magnetic resonance imaging is done by the specialist who conducted the study. In the photographs, the doctor captures pathological changes in the prostate. The specialist sends the resulting conclusion to the attending physician or gives it personally to the patient. Based on the description of the changes, the urologist prescribes an adequate treatment for the diagnosis. The high accuracy of MRI helps to identify the problem, its specifics in time, and form a system for eliminating the pathology.

Prostate MRI Price

The cost of the procedure varies depending on the region where the clinic is located, the method of performing prostate tomography. The average price in Moscow hospitals can be expressed using the table:

Why is an MRI of the prostate done in men and what does the study show

The most informative and safest type of examination of internal organs is magnetic resonance imaging. MRI of the prostate allows you to more accurately determine the nature of the disease, to make an accurate diagnosis in the initial stage. Prostate tumors are diagnosed with an accuracy of a millimeter, so after diagnosis, it is easier for a doctor to perform an operation to remove an adenoma or a malignant neoplasm.

Other methods - X-ray, ultrasound, TRUS are also used to examine the prostate gland or other organs of the human body. They have their own characteristics, so the indicators do not always correspond to the real picture of the disease.

How it works

This article will discuss issues related to magnetic tomography:

• what kind of examination is this;
• why do it;
• what it shows;
• how it is done;
• what the picture and the doctor's conclusion look like;
• what else can show;
• what type of examination to choose - tomography or ultrasound;
• can tomography detect prostate cancer at an early stage;
• how much does the procedure cost.

And also, what next tests should be done after the diagnosis, when can an MRI be done after a biopsy.

The device creates a strong magnetic field that excites hydrogen atoms in the human body. Atoms respond.

All diagnostics are based on the behavior of positively charged hydrogen particles.

A feature of magnetic resonance imaging is that it "sees" soft tissues better, therefore it is well suited for examining the prostate gland in men.

Sensitive detectors pick up radio waves passing through tissues and record the results as an image. On the computer, the doctor receives pictures of the body in a section, that is, in layers.

Take note! The examination makes it possible to determine prostatitis in the initial stage.

Neoplasms that have just appeared are already visible, so treatment can be carried out immediately after receiving the results.

Comparison of the magnetic method and TRUS

Prostate diagnostics is also carried out by other methods:

• ultrasound - ultrasound;
• transrectal ultrasound - TRUS.

These methods are similar in principle of operation, since they are based on ultrasound, which is reflected from tissues. During a routine examination, the ultrasound scanner is located in the lower abdomen. In the second, it is administered rectally.

What is better and more informative: ultrasound or TRUS? A sensor located in the rectum gives a more complete picture of the organ. But the procedure requires special measures:

• enema just before the start of the examination;
• no contraindications - acute stage of hemorrhoids, anal fissures;
• full bladder.

Ultrasound of the prostate may be more appropriate when an examination is urgently needed and there is no time for preparation.

If you choose MRI or ultrasound, then both methods are used here. Usually in sequence. Ultrasound is cheaper, allows you to see the problem in general terms. Next comes the turn of tomography to make an accurate diagnosis.

Indications for tomography

TRUS or MRI of the prostate is prescribed after the patient complains of difficulty urinating or urinary retention. Indications may be pain:

• lower abdomen;
• after intercourse;
• for ejaculation;
• in the urethra.

For sexual disorders - premature ejaculation, lack of erection, problems with potency - a diagnostic examination using a tomograph is also prescribed.

Should I do two studies? The organ is completely visible on tomography, so it makes no sense to spend money on additional measures.

This is the most expensive and effective method at any stage of the disease.

It is better to immediately go for magnetic resonance imaging than to do several semi-informative analyzes, collect information in parts.

Prostatic hyperplasia - tomography is prescribed after a manual examination in the doctor's office. Hyperplasia is a growing nodes, the number and location of which is to be determined by making a diagnosis. After infectious diseases, changes in hormonal levels, with poor heredity, a sedentary lifestyle, there is a chance that the tomograph will show changes in the gland.

The study of the organ helps to accurately determine the benignity or malignancy of the tumor process. The initial stage is an adenoma. MRI of prostate adenoma is done before surgery to accurately determine the volume of tissues, the number of nodes. MRI for adenoma allows you to distinguish it from cancer.

If you suspect the presence of cancer, the study is carried out before the biopsy procedure, so as not to injure the organ in vain. Diagnosis of prostate cancer using a tomograph makes it possible to find out which tissues of the organ are growing, since only glandular tissue grows in a malignant neoplasm. The presence of metastases in the lymph nodes and neighboring organs allows you to determine the area of surgical intervention.

The process can be diagnosed before the onset of characteristic pain, treated and prevent the appearance of metastases. Modern diagnostic methods make it possible to recognize the nature of the tumor even with its microscopic size.

Useful video: MRI of the prostate, how and when it is done, description of the procedure

Types of prostate MRI

The examination is carried out in several ways, depending on the indications:

• by the usual method - without the use of contrast agents;
• MRI of the prostate with contrast;
• multiparametric study;
• spectroscopy.

The type of study is chosen by the doctor, based on previous tests, the patient's condition, and the capabilities of the equipment.

The device can be of two types - open or closed

The doctor is in another room during the procedure, but can talk to the patient through a special intercom.

If suddenly a person feels bad or frightened, the procedure can be interrupted and find out exactly what happened.

Some patients are unaware that they have claustrophobia - the fear of closed spaces.

In an open device, the magnet is located on the sides. The quality of the research does not change. If you have a psychological fear of a closed room, you need to use an open-type apparatus.

Contrast

MRI of the prostate with contrast is used if necessary to identify abnormal cells in the tissues. In normal cells, the amount of water is greater, in atypical cells it is reduced. This criterion determines which cells predominate. The device sees the difference and transmits it as an image to the doctor's computer. For MRI with contrast, a substance containing iron oxide or manganese is used. More modern preparations are based on gadolinium. This rare metal is very toxic, so some countries have already banned its use.

• for MRI with adenoma;
• MRI for prostate cancer;
• MRI testicles;
• Multiparametric MRI of the prostate.

Drugs are administered intravenously. For tomography of the prostate gland with contrast, one of the types is used:

The contrast agent must be strictly timed and coincide with the beginning of the procedure.

No contrast

In spectroscopy, a special endorectal cuff is used for better visual reflection of tissues. It is lubricated with petroleum jelly or other lubricant and injected into the rectum. The cuff is inflated and fixed motionless at all times, contributing to a qualitative study. Diagnostics is carried out within half an hour, then the cuff is removed. The anatomy of the structure of the small pelvis contributes to painless installation and removal of the cuff, so it does not cause discomfort.

Multiparametric MRI

Multiparametric MRI of the prostate is the most informative method in the early stages of diagnosing malignant tumors.

Prostate cancer has a specific pattern of blood flow, chemical parameters, and appearance.

Tomography for adenoma is sometimes performed with the simultaneous taking of biomaterial for analysis.

Prostate biopsy is carried out under visual control, which makes it possible to examine the most suspicious tissue areas.

Multiparametric MRI in prostate cancer can detect the smallest nodes and contribute to the complete removal of the tumor during surgery. Diagnostics allows to detect prostate cancer at the stage of metastases, at the beginning of their appearance.

Multiparametric examination of the prostate for prostatitis increases the chances of a complete cure.

Contraindications and side effects

Tomography of the prostate, testicles and other internal organs is absolutely contraindicated in the presence of:

• metal particles in the body - prostheses, pacemakers, pins;
• various implants, including those located far from the study site;
• artificial heart valves;
• metal dentures

The magnetic field can change the operation of electronic devices in the human body, so the examination of the prostate using the tomography method should be carried out by other available methods.

The procedure with contrast is contraindicated for pregnant women.

Side effects of the procedure may include dizziness, reactions to the contrast agent. Signs of poor health do not require special treatment.

Examination progress step by step

For a procedure using rectal probes, you need to empty your rectum. To prepare for the examination, you need:

• limit foods that cause flatulence;
• do not eat 4 hours before the test;
• Tell your doctor if you are allergic to any medications.

Preparation should include taking sedatives to reduce claustrophobic anxiety.

Next, tomography is performed according to the following algorithm:

If the patient is being examined for the first time, he may be confused by the loud sound emitted by the device.He no longer experiences any discomfort. Prolonged immobility, which is necessary for high-quality results, is also unusual.

The examination with a rectal probe causes more discomfort in men. If there are problems in the anus, painful symptoms of a low degree of intensity are possible. This method uses lubricants to facilitate the penetration of the transducer into the rectum.

Transcript of results

The PI-RADS assessment of the results of a prostate examination is intended to determine the presence of a cancerous tumor. How to determine cancer using this system:

• score 1 means the least similarity to a malignant process;
• 2 - the neoplasm is probably benign;
• 3 - ownership is not determined;
• 4 - probably malignant;
• 5 - most likely a cancerous tumor.

The diagnosis of prostate cancer is based on results above 3. MRI of prostate adenoma is at level 2 and 3.

Biopsy of the prostate and classification according to the Gleason scale will confirm that the tumor belongs to one of the species.

To get the results of a tomography, cancer is diagnosed histologically by pinching off a small piece of tissue for examination.

The time difference between the two procedures should be at least 4 weeks.

Tomography can be done before the biopsy. The diagnosis will be made faster. Examination with a tomograph after a Prostate biopsy will take longer.

Cost of the procedure

The price of the procedure depends on the power of the device, its convenience for people with high weight and psychological problems.

The problem is that the queue is formed in advance and you can wait about a month.

Private clinics set higher prices, but conduct examinations faster. The conclusion of a specialist can be obtained an hour after the diagnosis.

Useful video: how an MRI of the prostate is performed

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