MRI of the prostate: nuances of the study and its necessity

MRI of the prostate is a diagnostic technique that allows you to confirm or refute prostatitis, adenoma, abscess or oncology.

During the examination, the structure of the organ, its dimensional characteristics are assessed, and the parameters of the neoplasms are assessed.

The accuracy of the method is close to 90%, which is significantly higher than in the case of ultrasound and computed tomography. If you combine a scan with a biopsy, this figure reaches 100%.

What does an MRI examination demonstrate?

The technique consists of translating into an image the resonating reaction of hydrogen atoms from tissues.

The magnetic field has a stimulating effect. As a result of the study, data on tomography, discreteness and other parameters of the prostate is provided.

In addition to differential diagnosis, the reason for MRI may be the need to study the organ before surgery.

MRI

The image will demonstrate the degree of damage to the prostate gland and the involvement of third-party blood vessels, bones, nerves and other structures in the pathology.

Thanks to tomography, a specialist can determine exactly what needs to be done during surgery.

In the course of scientific research, it was found that the probability of detecting a developing malignant tumor during ultrasound is 62%.

TRUS is somewhat more accurate - it can diagnose cancer in 77%. The accuracy of magnetic tomography without biopsy is 89%, with combined diagnostics - 100%.

TRUSY

Despite the fact that diagnostic accuracy is low, ultrasound and TRUS are used much more often. The reason for this is the presence of contraindications and the high cost of MRI.

For medical reasons, MRI is performed before prostate biopsy. The length of the break between manipulations is unimportant. The procedure is carried out under magnetic tomography control.

The advantage of such a “double” study is that specialists do not take tissue “blindly”, but in certain areas.

The result is that the likelihood of making an accurate diagnosis increases and the risks of complications are reduced.

Biopsy

If the order of the procedures was violated—the tissue was taken before the MRI—then the tomography can be performed no earlier than 25 days after the collection. During this period, the injured prostate will have time to recover.

Preparing for an MRI examination

Before MRI diagnostics of the prostate gland, a man will have to carry out a number of preparatory measures:

1. Prepare documentation: referral, results of previous studies, including laboratory tests (urine and blood tests).
2. A day before the tomography, stop eating foods that stimulate gas formation: legumes, brown bread, cabbage dishes, etc. To avoid discomfort, take Espumisan.
3. Empty your bowels before testing. If necessary, use a cleansing enema (especially important when using a rectal coil).
4. Do not eat 4 hours before the MRI.
5. 60 minutes before the scan, drink 1 liter of water to fill your bladder.
6. Before the procedure, drink an antispasmodic, for example, “No-shpu”.
7. In case of severe anxiety, you can use a sedative.

Progress of MRI examination of the prostate

Examination of the prostate gland using MRI diagnostics is carried out according to the following scheme:

• The patient hands over metal objects (jewelry, glasses, watches, clothing) and changes into disposable clothing.
• The patient is placed in a tomograph. In case of prostatitis, prostate cancer, abscesses or hypertension, only the pelvic area is examined. For this reason, a person is not completely inside the tomograph tunnel—the head and upper limbs remain outside the apparatus. The subject may not close his eyes, read a book or listen to music; it is only important to keep the lower part of the body still.
• The tomograph ring begins to move. The patient does not experience any discomfort. The procedure takes 30-70 minutes. During this time, up to 20 pictures are taken.
• At the end of the diagnosis, the patient gets up, changes clothes and leaves the diagnostic room.

Traditional way

• Conventional magnetic resonance imaging of the prostate is the simplest procedure.
• It is prescribed extremely rarely, since in this case there is a high probability of “missing” oncology.
• Non-contrast MRI is performed if there are contraindications to the use of an alternative technique and has a number of advantages.

We are talking about a reduced price of services and the absence of the risk of developing an allergy to contrast. Among the disadvantages, it is worth noting the low information content of the study in case of suspected tumor development. The accuracy rate of MRI under such conditions is 78%.

Diagnostics using contrast

MRI of the prostate with contrast is performed to assess organ parameters and identify tumor processes at the initial stage of development.

Gadolinium-based substances act as a contrast agent. This composition is a metal with a silvery tint, which is clearly visualized during magnetic tomography.

1. Contrast is injected before placing the patient inside the tomograph.
2. Over the next 3 minutes, the contrast agent in the blood reaches the gland and scanning can begin.
3. 24 hours after the end of the diagnosis, the contrast leaves the patient’s body along with urine.
4. Contraindications to conducting studies using a contrast agent include:

• allergic reaction to the component;
• liver failure;
• recent heart attack;
• blood diseases.

Multiparametric MRI

To obtain an accurate result, a multi-parameter information analysis algorithm is used.

Scanning is carried out using a traditional device (today, targeted MRI is more often used, which involves examining an organ using ultra-high-field equipment).

Multiparametric tomography requires more time (half an hour). The period for analyzing the results is also extended.

This MRI diagnostic method helps to exclude a biopsy. The risk of “missing” oncology, compared with conventional tomography, is reduced by 12%.

MRI with dynamic contrast

The procedure helps to study the speed and nature of the passage of contrast after its administration.

In malignant neoplasms, rapid absorption of the drug and the same rapid “washing out” of it are observed, in comparison with unchanged structures.

Diagnosis using fat suppression

We are talking about DWI or diffuse-weighted image. This type of MRI helps to visualize a “picture” of metabolic processes taking place at the molecular level.

The basis of the study is the determination of the diffusion of water molecules. In damaged areas this process occurs differently. This makes it possible to differentiate the diagnosis.

In malignant tumors, the cell density is higher, therefore, diffusion is reduced. The image is assessed visually and quantitatively.

MRI for oncology

The reason for prescribing diagnostics is high PSA in the blood. An increased antigen content indicates adenoma, purulent prostatitis, abscess, and oncology. Magnetic tomography helps make an accurate diagnosis.

With prostate cancer, dense accumulations are visualized on an MRI image, which are absent in a healthy organ.

During the scan, it becomes possible to identify the form of oncology. For example, a weak resonance “speaks” of the development of a tumor formed by cells with mucin.

A biopsy is performed to determine the nature of the tumor (malignant or benign).

Interpretation of MRI diagnostic results

The diagnostician deciphers the received data.

When analyzing the images, the specialist forms a conclusion, on the basis of which the urologist makes one of the probable diagnoses presented in the table below:

Diagnosis Appearance on MRI

There are no pathologies	The dimensional characteristics of the organ, its capsule, testes, surrounding tissue, vascular system and nerves are normal. Tumor processes are not visualized
Benign hypertension	Organ growth (asymmetrical or symmetrical). The contours of the gland are uniform
Prostatitis	The size of the gland is increased, the contour is unclear (due to weakened blood supply)
Malignant neoplasm (PCa)	Single or multiple formation. Has a point localization or “settles” behind the capsule of the gland

MRI image of prostate (cancer)

An accurate diagnosis is made taking into account the results of other examinations - ultrasound, PSA, etc.

Cost of MRI examination

The cost of MRI diagnostics of the prostate is high when compared with the cost of other procedures.

This price tag is explained by the use of expensive equipment and the complexity of diagnostics.

If you have to conduct a magnetic tomography with tissue sampling, you need to pay about 9,500 rubles.

In some medical centers, parallel examination of the pelvic organs is possible. This procedure costs about 12,000 rubles.

MRI of the prostate gland is highly likely to diagnose oncology, especially if a combination of magnetic tomography and biopsy is provided.

In addition to suspected cancer, indications for scanning include symptoms of adenoma, inflammatory processes, prostatitis, as well as the preoperative period.

The procedure involves carrying out preparatory activities. Diagnostics lasts from 30 to 70 minutes.

Contrast may be used during research. In some cases, MRI with dynamic contrast, fat suppression, and multiparametric tomography is justified.

The diagnostician deciphers the received data. This process takes no more than an hour.

The specialist’s conclusion is transmitted to the attending physician for diagnosis. The cost of magnetic tomography is high and ranges from 5,500-12,000 rubles across the country, depending on the type of diagnosis.

Video

Source: https://osnimke.ru/malyj-taz/mrt-prostaty.html

MRI of the prostate - preparation and diagnostics with contrast

Prostate MRI is a basic procedure for diagnosing serious prostate diseases in men. A highly accurate research method ensures the effectiveness of subsequent treatment of the male organ, this is especially important for prostate cancer.

What it is

MRI or magnetic resonance imaging is the most effective and safe method for identifying tumors in the prostate gland. The MRI technique diagnoses pathologies using irradiation with a magnetic field generated by a tomograph. The device produces results in the form of clear photographs of the organ; the images allow you to see a complete picture of the condition of the organ.

Magnetic resonance imaging is safe for human health, however, in order to avoid unnecessary radiation, MRI is recommended to be performed no more than once a year. If necessary, the procedure is carried out as many times as the diagnosis requires.

Why is it carried out?

MRI of the prostate gland diagnoses malignant tumors of the organ; MRI for cancer is the main diagnostic procedure that allows you to identify oncology in the early stages and begin its treatment in a timely manner. Magnetic resonance imaging is also done to detect the presence of tumor cells behind bone structures, which other methods cannot guarantee.

MRI of the prostate allows you to detect hidden anomalies and inflammatory processes; using this method, doctors can assess the structure of the gland and the degree of involvement of surrounding tissues.

In addition to cancer, MRI is also indicated for the following conditions:

• benign neoplasms of the prostate gland;
• prostatitis is an inflammatory process in the organ;
• prostate abscess.

The MRI procedure is prescribed not only for diagnosis, but also to control the stages of treatment, this allows you to timely assess their effectiveness and choose the most accurate treatment tactics.

Preparation before MRI

Preparing for a prostate MRI does not require complex steps. Before conducting a diagnostic study, one day it is necessary to exclude from the diet foods high in coarse fiber - vegetables, fruits, brown bread, as well as products that increase gas formation - sparkling water, fermented milk products, legumes. If the body is prone to increased gas formation, the patient is recommended to take activated charcoal.

In the evening, on the eve of magnetic resonance imaging, a cleansing enema is given or a laxative is taken.

You must stop eating 4 hours before the procedure; you should not drink a lot of fluids before the diagnostic test, but the bladder should be partially filled, since when performing an MRI of the prostate gland, the bladder is also captured to detect the inflammatory process or the transition of cancer cells. You must refrain from urinating one and a half to two hours before the diagnosis.

During the procedure, the patient must lie still at all times to obtain clear images, but the procedure itself often causes fear and anxiety in the person. Patients are advised to take sedative (calming) medications before undergoing an MRI procedure.

Since the tomograph creates a magnetic field, before entering the office the patient must remove all metal objects and other things that the device can attract, this list includes:

• jewelry and watches;
• belts with metal buckles;
• clothing with zippers and studs;
• pins;
• piercing;
• removable dentures;
• glasses;
• pens;
• bank cards;
• Hearing Aids.

Note! The procedure is contraindicated for people who have permanent implants, prostheses, a pacemaker, and so on.

How is magnetic resonance imaging done?

MRI of the prostate gland is performed using a machine in the form of a cylindrical tube around which there is a powerful magnet. Before starting the procedure, the patient lies down on a special table, which is placed inside the cylinder. Before turning on the tomograph, the staff leaves the procedure room and observes the MRI from another room with a glass window, monitoring the process using a computer.

The duration of the diagnostic procedure takes no more than half an hour; when performing an MRI of prostate adenoma or other pathology with contrast, the duration increases to one hour. In some cases, the doctor additionally performs spectroscopy; this procedure provides additional information about the composition of the cells.

MRI for prostatitis or cancer does not cause pain in patients; men can feel warmth under the influence of the magnetic field. When a contrast agent is administered, the body's normal reactions are a metallic taste in the mouth and a burning sensation in the prostate.

After magnetic resonance imaging, there is no recovery time required for the body; the patient can immediately go home and begin normal activities and eat food. MRI results are released the next day after the diagnostic study.

MRI with contrast agent

MRI for cancer with contrast allows you to determine the exact location of the affected cells. The dye accumulates in damaged tissues, which improves image clarity and allows you to accurately determine the size of tumors.

MRI with contrast is contraindicated in patients with allergies. Although the substance gadolinium is most often used instead of iodine, there is still a risk of developing sensitization of the body.

The price for magnetic resonance imaging of the prostate varies from 2500 to 7500 rubles. The cost depends on the reputation of the clinic and the region of its location.

Indications

Indications for the procedure:

• prostate cancer;
• benign prostatic hyperplasia;
• prostate abscess;
• prostatitis;
• control in the treatment of prostate diseases.

An MRI procedure gives a chance for timely detection of the disease and maximizes the success and effectiveness of treatment.

Source: https://DiagnostLab.ru/mrt/bryushnoj-polosti/mrt-prostaty.html

MRI of the prostate: preparation

Preparing the patient for examination of the prostate on a magnetic resonance imaging scanner

The prostate is responsible for the condition of the male reproductive system and performs many other functions.

An unbalanced diet, decreased physical activity, and neglect of one’s own health contribute to the development of pathologies that affect the body and significantly worsen the quality of life.

Magnetic resonance imaging is one of the best methods for diagnosing prostate diseases. Proper preparation for MRI of the prostate contributes to high accuracy of images, due to which abnormalities in the organ are successfully detected in the early stages.

Preparation for MRI examination of the prostate gland in men

Proper preparation for an MRI of the prostate includes several points:

• Diet. Two days before organ scanning, you should remove from your diet all foods that cause flatulence: legumes, any raw vegetables and fruits, milk and products made from it, fried foods, smoked foods, pickles, marinades, brown bread, baked goods, confectionery, carbonated drinks.
• Purgation. When the gastrointestinal tract is functioning normally, it is enough to go to the toilet as usual. If you are prone to constipation, give an enema or use a laxative.
• Taking antispasmodics and drugs to prevent gas formation. Medicines are prescribed only by the attending physician.

One of the ways to cleanse the intestines before an MRI scan of the prostate is to perform an enema.

Come to the procedure on an empty stomach.

If the prostate scan is scheduled for the morning, breakfast is skipped; if the appointment is for the afternoon, food intake is allowed 4-6 hours before the appointed time (you can eat something easily digestible - porridge with water, yogurt, a sandwich with low-fat cheese) . Lightly brewed tea and still water are preferred drinks. Stop taking liquids 4 hours before the examination.

During the procedure, the bladder should be moderately full. It is emptied no later than two hours before the start of the MRI session.

MRI of the prostate in contrast mode: preparation

Contrast agent for intravenous administration

If an MRI of the prostate with a paramagnetic contrast agent is expected, the patient is prepared for the study in the same order. If a man is prone to developing allergic reactions, he needs to do a test in advance. If you have identified or suspected kidney or liver diseases, a blood test may be required to assess the functionality of these organs.

Prostate MRI: what does it show?

Most often, nuclear magnetic diagnostics is used to detect malignant prostate tumors. MRI finds tiny tumors in the anterior peripheral zone that are inaccessible for visualization using transrectal ultrasound.

Prostate gland: comparison of magnetic tomograms of a healthy and sick person

Tomography helps:

• determine the size of the tumor;
• establish the spread of pathology beyond the gland capsule;
• identify the involvement of the urethra, bladder, seminal vesicles, surrounding tissue, and lymph nodes in the oncological process;
• see metastatic foci on the pelvic bones and sacrum.

MRI also shows:

• inflammatory lesions of the organ (prostatitis, abscesses);
• adenomas;
• congenital anomalies (hyperplasia, hypoplasia, etc.);
• consequences of traumatic injuries.

How is an MRI scan of the prostate done?

There are several ways to study the prostate:

• Classic - conventional non-contrast magnetic resonance imaging.
• With the use of an endorectal coil - for maximum accuracy of examination results, an additional sensor is placed on a flexible wire in close proximity to the prostate gland.
• With contrast - an intravenous injection of a drug with a dye is made, which is distributed throughout the tissues and improves the visibility of pathologically changed areas.
• MR spectroscopy is carried out specifically to study the chemical composition of the prostate gland. A healthy organ is characterized by a high concentration of citric acid. When malignant tumors occur, its amount decreases with a simultaneous increase in the level of choline, which is part of the cell membrane.
• Multiparametric MRI. This study combines all types of tomography.

Endorectal coil

The patient must bring the results of previous examinations, if any, for diagnosis.

The magnets of the tomograph create a powerful field, so before entering the office, you need to remove objects with metal from yourself:

• watch;
• glasses;
• belt;
• clothes with rivets and zippers;
• piercing jewelry;
• dentures, etc.

Phones, wallets, bank cards, pens and other personal items are left behind the control room door.

The session lasts 30-40 minutes. If an endorectal coil is to be used, the patient may be given an anesthetic injection half an hour before the scan.

The tomograph is a complex device that includes a cylindrical tunnel and a retractable table. The man lies down on his back. To prevent involuntary movements, the body and limbs are secured with straps. To muffle the noise of a working device, use headphones or earbuds.

Magnetic resonance imaging

For endorectal examination, a coil in a special case is lubricated with lubricant and placed in the rectum. The balloon surrounding the sensor is inflated, allowing the scanner to position itself correctly.

After preparation, the device takes native images. If necessary, contrast is administered to the patient during the examination and the procedure is continued. At the end of the scan, the balloon is deflated, the coil is removed, and the patient can get up from the table.

Indications and contraindications for MRI of the prostate gland

Indications for MR imaging of the prostate are:

• suspicion of malignant formation, metastases;
• prostatitis;
• cysts;
• adenoma;
• infectious (including sexually transmitted) diseases;
• congenital anomalies of the prostate gland;
• viral, fungal diseases;
• inflammatory processes;
• complications after surgical treatment of an organ.

Using MRI, you can visualize the structure of the prostate, detect hidden pathologies, and assess the degree of involvement of surrounding tissues in the process.

On magnetic resonance imaging (a - axial section; b - sagittal section), arrows show progressive cancer spreading to the orifices of the seminal vesicles

Magnetic resonance diagnostics is absolutely contraindicated if there are metal objects or electronic devices in (on) the man’s body, which include:

• pacemakers;
• middle ear implants;
• joint prostheses;
• plates, staples, screws, screws, etc., used in surgery;
• compression-distraction device;
• damaging elements (bullets, shot, fragments, etc.), metal shavings;
• insulin pump;
• clips on vessels;
• myostimulator with ferromagnetic elements;
• artificial heart valve (if it is not made of polymers or biological tissue).

Relative contraindications:

• fear of closed spaces (for mild forms of claustrophobia, sedatives help prepare for an MRI);
• inability to stay in one position for a long time;
• weight more than 120 kg (this limitation is due to the design features of tunnel-type tomographs).

Examination with contrast is not performed if:

• allergies to drug components;
• severe liver damage, during the rehabilitation period after organ transplantation;
• end-stage renal failure.

Interpretation of MRI images of the prostate gland

During the procedure, the doctor receives detailed information about the condition of the prostate itself and the organs that are adjacent to it (bladder, lymph nodes, lower intestine).

In the absence of abnormalities, the sizes of the prostate gland, testes, nerves and vessels are normal, and no tumors are detected.

Pathologies can appear on images in the form of prostate growth, changes in its contours, display of single or multiple neoplasms inside or outside the capsule.

Discussion with a specialist about the results of MRI of the prostate gland

The tomograms are deciphered by the specialist who conducted the study. The conclusion about the nature of the changes is not considered a diagnosis. The final analysis of the information obtained and the selection of an adequate method of therapy is the task of the attending physician.

Source: https://vsemrt.ru/mrt-diagnostic/mrt-predstatelnoj-zhelezy-podgotovka/

MRI of the prostate – for whom is it necessary, who is contraindicated and how is it performed?

Home » MRI » MRI of the prostate (prostate) what is it and who needs it?

Using MRI, it is possible to detect prostate diseases in men that cannot be identified in any other way. Let's consider when MRI of the prostate gland is performed, what can be detected using MRI - and what are the nuances of this procedure.

What is it and when is it done?

Magnetic resonance imaging is a study that involves creating clear images of internal organs (in this case, the prostate) through the action of magnetic fields.

Most often, such an MRI is performed for cancer localized in the prostate, or more precisely, when its presence is suspected. The image shown by MRI, in such a case, will reveal what stage the disease is in, whether it develops only in the prostate gland or has already spread beyond its limits.

In this case, the first signs that a diagnosis needs to be made may include symptoms such as urinary disturbances, the urge to urinate at night, and the presence of blood particles in the urine.

But although this study is most often performed for prostate cancer, this is not the only indication for the procedure. It is also carried out if the following diseases are suspected:

• Prostatic hyperplasia, also known as benign adenoma. It occurs when glandular tissue grows too much, causing the urethra to become compressed. Although the problem cannot spread beyond the gland, it is difficult to diagnose it symptomatically at an early stage, so MRI can be a great help in diagnosis.
• Prostatitis. An inflammatory process that develops as a result of exposure to bacteria. As a result, the prostate begins to function worse, abscesses and purulent discharge may occur. MRI helps with all types of prostatitis, both chronic and acute or stagnant.

It is also possible to have an MRI of prostate adenoma and other examination options as prescribed by the doctor.

Preparation

No serious preparation for the study is required. But the day before the procedure, it is recommended not to eat foods that contain coarse fiber. 4 hours before the procedure, you should completely stop eating, and 1.5 hours from urinating - the bladder should be slightly full, although it is not recommended to drink a lot of liquid.

All metal jewelry should be removed before using the device.

Process

When preparation for an MRI of the prostate is completed, the patient is placed on a special horizontal table, which slides into a special apparatus in which the observed person is surrounded on all sides by special magnets. Next, he needs to lie still for some time until the necessary data is collected.

Optionally, the process can be supplemented with the following procedures:

• Insertion of a special rectal coil, which is placed in the rectum in a special cuff.
• Injection of contrast fluid. Carrying out the procedure together with contrast in some situations can facilitate further analysis of the results obtained.

Contraindications

In some cases, prostate examination using magnetic resonance imaging is not recommended. These include:

• Allergy to contrast agent (it is prohibited to perform MRI of the prostate with contrast, but regular MRI is possible).
• Excessive weight.
• Presence of pacemakers, insulin pumps and any other implants containing metal.
• Claustrophobia, making it difficult to stay inside an apparatus that is closed.

The question often arises whether MRI is possible after a biopsy. Moreover, after a prostate biopsy, an MRI is not only possible, but even recommended, to confirm the diagnosis.

Possible alternatives

If for some reason an MRI of the prostate gland cannot be done, there are several, albeit not entirely similar, but also effective ways to examine the prostate. These include:

• Ultrasound is an ultrasound examination of organs. A simple, cheap method in which a special sensor is inserted into the rectum. This allows you to increase the accuracy of the procedure, but it is not particularly pleasant.
• CT scan. It is distinguished by accuracy, but at the same time, during the procedure a person is exposed to ionizing radiation, which is harmful to the body in large quantities.
• Digital rectal examination. For objective and obvious reasons, it cannot even come close to competing in accuracy with other diagnostic methods, but as a simple and cheap first aid measure, it is a fairly good option.

What is best to do and whether it is worth resorting to alternatives at all is a decision made by the attending physician.

Let's sum it up

If there is even a slight suspicion of the presence of malignant or benign diseases of the prostate gland or other pathologies, you cannot do without an MRI, which allows you to examine the prostate and show whether everything is fine with it. If it cannot be used by any means, you can always choose an effective and efficient alternative that will allow you to diagnose diseases and pathologies occurring in this gland.

Source: https://proskopiyu.ru/mrt/mrt-prostaty.html

MRI of the prostate - what the study represents

One of the highly informative diagnostic methods is magnetic resonance imaging.

The examination allows you to identify many diseases in the initial stage, carefully examine the prostate gland and its surrounding tissues. Tomography is painless, does not cause discomfort, and does not cause harm to health.

You will learn how an ultrasound of the liver is performed and what it shows in this article - https://aboutrentgen.ru/uzi/uzi-pecheni

Information content of the method

When diagnosing the prostate using magnetic resonance imaging, any changes in the organ are detected, especially if there is suspicion of cancer after the results of a biopsy and tumor markers. Tomography provides layer-by-layer images and helps visualize tumor growth. MRI helps determine:

• prostate adenoma (benign neoplasm);
• inflammatory process;
• cancer.

In the presence of oncology, the lesion can be detected at the initial stage. This allows you to prevent the spread of the malignant process and metastasis. Compared to other methods (ultrasound, x-ray, etc.), MRI is highly informative and resolution, which helps detect even very small formations. Tomography can be performed with or without contrast.

Types of MRI

During an MRI, organs are exposed to a magnetic field. Tissues absorb it differently, depending on the structures. Highly sensitive devices pick up the slightest vibrations and send data to the computer. After instant processing using a special program, a cycle of layer-by-layer scans is obtained. There are several types of MRI:

1. The classic option is when the patient lies on the tomograph table, which slides into the tunnel. After turning on the device, scanning of the prostate and surrounding tissues begins.
2. MRI with contrast (see https://aboutrentgen.ru/mrt/mrt-s-kontrastom). It is injected into the bloodstream before the scan. The contrast is distributed throughout the tissues and helps to more accurately determine the affected areas, their size, and boundaries. Such a study is usually prescribed when breast cancer is suspected.
3. Examination with an endorectal MRI coil. This increases the information content of the study, since the resolution in the area under study increases significantly, the clarity of noise, signals, neurovascular bundles, and the image of the gland increases.
4. Multiparametric MRI. This method combines all tomography methods into one, the advantage of which is the detection of cancer in the early stages. This examination eliminates possible errors. The method is often combined with a biopsy and helps to identify and examine the most aggressive pathological areas and the extent of the spread of the malignant process.
5. MR spectroscopy allows you to study the chemical composition of prostate cells. This is an additional study that is carried out during a tomography. Due to this, the examination time increases by approximately 15 minutes. Spectroscopy helps to identify tumors in the center of the organ and on the periphery in a non-invasive way.

All methods have certain advantages, some have nuances in preparation. The main requirement is the absence of metal implants, which can fail and negatively affect health.

Indications and prohibitions for examination

The prostate gland is an important organ in the male genitourinary system, controlling the production of substances that support the viability of sperm. The prostate is subjected to a lot of stress and often becomes vulnerable due to many diseases. MRI is prescribed for:

• frequent urge to urinate;
• pain when emptying the bladder;
• the appearance of blood in urine;
• if the bladder does not empty completely;
• disruption of the genitourinary system;
• any stages of prostatitis;
• tattoos whose ink contains metal;
• suspected cancer or metastases;
• prostate adenoma;
• detecting a tumor at an early stage;
• to evaluate nearby lymph nodes.

The main reason for tomography remains cancer in the gland. The examination is carried out after cytology or histology, with the help of which the material taken during the biopsy is studied. MRI is done before operations (especially at stages 2 and 3 of cancer), radiation and chemotherapy, to monitor the patient’s condition after treatment, to prevent relapse.

Contraindications

Tomography has a small list of contraindications. The absolute ones include the presence of permanent metal implants in a person (in the inner ear, vascular shunts, hemostatic clips, pacemakers, heart valves).

In this case, the examination is not carried out if less than three months have passed since installation. In some cases, modern implants may not pose a risk, but in this case, documentary evidence must be provided.

Contrast-enhanced tomography is not performed on patients with kidney disease. However, relative prohibitions can be circumvented. If you are overweight, the examination can be carried out on an open tomograph, which allows you to examine only a certain area. The inability to remain still can be corrected with sedatives or anesthesia.

Preparing for an MRI

MRI does not require lengthy preparation, but to obtain more accurate results, it is advisable to adhere to the general recommendations of doctors:

1. A couple of days before the procedure, exclude from the diet everything that can cause flatulence (flour, sweets, legumes, cabbage, vegetables and fruits, dairy products, lemonades, alcohol, etc.).
2. To prevent gas formation, Espumisan or activated carbon is taken for 3 days before the examination (the dosage is calculated individually, depending on weight).
3. On the eve of the study, the intestines are cleansed with an enema.
4. Power is cut off 4 hours before the scan.
5. 2 hours before the examination, the bladder is partially filled (for this you need to drink a liter of still water).
6. 30 minutes before the procedure, you can take a sedative or antispasmodic.

If the patient has the results of previous examinations or photographs, they need to be shown to the doctor for comparison. When an MRI is performed with contrast, an allergy test must be done first.

Conducting research

Despite the types of tomography, in general it is performed according to the classical version. The patient undresses and lies on the tomograph couch on his back. The body is secured with soft straps to prevent involuntary movements. For better visualization, small magnets are sometimes attached to the lower back and lower abdomen. Then the tomograph turns on and scanning begins.

Performing an MRI with an endorectal coil is somewhat different. Before scanning, a cover is put on it and covered with a special gel. The coil is then inserted into the anus and advanced into the rectum. The balloon is inflated and secured in the desired position. Next, the procedure follows the classic version.

When the scan is completed, the balloon is deflated and removed. If it is necessary to obtain additional sections, the examination is repeated. The procedure performed with a coil may cause only some discomfort in the form of slight pressure in the intestine, but no pain is felt.

If it is necessary to use contrast, it is administered to the patient intravenously or orally through the mouth. Tomography differs from the standard version. First, a series of photographs are taken, then contrast is introduced. The scanning then continues. A man may feel a slight burning sensation, which is normal.

Spectroscopy is carried out during a classic scan; due to this intervention, the diagnosis lasts slightly longer. On average, it takes about 30-45 minutes.

Despite the harmlessness of MRI, it is advisable to wait at least a month before the next examination.

Decoding the results

Decryption takes some time. The diagnostician evaluates not only the prostate gland, its size, structure, but also the tissues adjacent to it, the bladder, and seminal vesicles. At the same time, the lower part of the rectum, adrenal glands, lungs and liver are examined (they may be affected by the process of metastasis). Most often, MRI determines:

1. Acute prostatitis. It is accompanied by swelling of the organ and periprostatic tissue. The venous plexus is noticeably enhanced.
2. Chronic prostatitis. At the same time, the structure is heterogeneous, the signals reflected from the tissues are of different strengths. The contours of the prostate are blurred, and areas of varying intensity are visible on tomograms. If there are stones, then the signals are barely received. Pathological lesions are cone-shaped, without mass effect. When an adenoma attaches, transistor cysts are visualized. They can even be found in the seminal vesicles.
3. Hyperplasia (benign). The glandular one is characterized by increased intensity, the stromal one – decreased. In the first case, cystic changes are visible in the middle of the gland. Post-inflammatory or retention formations are usually located on the periphery. In the stromal form of the disease, detecting oncological foci located in the center of the organ is quite difficult. With highly developed hyperplasia, the peripheral area is highly compressed, which creates difficulties in detecting the tumor.
4. Adenocarcinoma of the prostate. It is characterized by low intensity. If uneven and blurred contours are visible, this may indicate the presence of a malignant tumor.
5. Metastasis. They are indicated by asymmetry of neurovascular bundles, extracapsular formation, and bulges at the borders of the prostate. In this case, the rectal prostatic angle is closed by tissue, and various hypointense signals emanate from the seminal vesicles.

Cancerous tumors are clearly visualized using contrast. It accumulates in pathological areas. Due to this, it is possible not only to accurately determine the location of the malignant neoplasm, but also to estimate its size and growth.

Iron is also assessed for the presence of cancer using the PI-RADS scale:

• the least similarity to a malignant formation is indicated by 1;
• for a benign tumor – 2;
• belonging to a malignant process cannot be determined – 3;
• high probability of cancer diagnosis – 4;
• the chance of diagnosing oncology is maximized – 5.

Cancer is diagnosed after a value of 3, prostate adenoma - 2 and 3. To accurately determine the nature of the tumor, a biopsy is done when a piece of tissue is pinched off from the tumor.

Thanks to MRI, serious and dangerous pathologies can be detected at the initial stage, since some diseases are asymptomatic during this period. This allows you to eliminate the disease in time, without leading to serious consequences and operations.

The only disadvantage of MRI is that the examination is expensive due to the high cost of the equipment.

Dr. E.N. Bogdanov

Source: https://aboutrentgen.ru/mrt/mrt-prostaty

Is it worth doing an MRI for prostatitis?

MRI of the prostate 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 of neighboring tissues in the spread of the disease. This is a harmless and highly informative technology of modern medicine. It differs from CT in its safety and more accurate results.

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

• Prostatitis is inflammation of the prostate gland in acute and chronic forms, as well as in the abscess phase with a layer of pus.
• Hyperplasia (adenoma) is the growth of connective tissue, resulting in compression of the urethra. The disease is dangerous with serious complications. Early detection is the key to effective treatment.
• Cancer. The problem of cure lies in diagnosing the disease in the first phase. At the beginning, the disease has no specific symptoms. Examination of the prostate gland using MRI provides the most high-quality and reliable data on the presence of cancer, its stage and location.

The organ under study is small in size and buried quite deeply in the body. In this regard, classical magnetic influence is not enough for high-quality diagnostics. In this case, the following are additionally assigned:

• MR spectroscopy. The result of the study is the chemical composition of the gland.
• MR diffusion/perfusion, which differentiates between normal and diseased tissues.

Types of MRI examination of the prostate:

• Classic study without the introduction of contrast markers and probe. The patient lies down on a table that slides into a large tube surrounded by a magnet. The desired area of ​​the body is scanned within 30-40 minutes.
• With contrast. Before the procedure, the patient is injected with a substance; traces of it are clearly visible on the screen. The blood carries the drug to all tissues, including the tumor. The contrast does no 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 clearer.
• Multiparametric MRI is a combination of all types of magnetic tomography.

Magnetic resonance imaging, including of the prostate gland, has high reliability of results, higher than other diagnostic methods.

In addition to this advantage, it, unlike computed tomography of the prostate gland, does not expose the patient to the harmful effects of x-rays.

The exception is people who have contraindications to MRI. A CT scan of the prostate gland is provided for them.

Advantages of magnetic resonance examination 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 conduct a chemical analysis of it;
• speed of research – the procedure lasts 30-40 minutes.

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

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

A magnetic resonance imaging scanner 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. MRI examination of the prostate is carried out as follows:

• The patient must change clothes in the locker room and deposit valuables, watches, and electronic devices.
• The doctor injects a gadolinium-based contrast agent into the vein, if contrast was provided. During a dynamic study, the patient is given a dropper with a saline solution, into which a marker is added after the start of the scan.
• If you intend to use an endorectal coil, the specialist prepares it as follows. A special cuff is smeared with Vaseline 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.

Source: https://mdroit.com/prostatit/stoit-li-delat-mrt-pri-prostatite/