Medical Center-Radiology, Bochum, Universitätsstr. 110e, 44799, Bochum, Germany.
Witten/Herdecke University, Witten, Germany.
Sci Rep. 2022 Feb 3;12(1):1840. doi: 10.1038/s41598-022-05909-1.
MR imaging provides awareness for rectoprostatic hematomas as a complication in prostate biopsy. We evaluated the frequency and size of clinically silent bleeding after in-bore MRI-guided prostate biopsy according to documentation in MRI. From 2007 until 2020 in-bore MRI-guided prostate biopsy was performed in 283 consecutive patients with suspected prostate cancer. Interventional image documentation was reviewed for rectoprostatic hematomas and rectal blood collections in this retrospective observational single-center study. Correlation to patient characteristics was analyzed using a multivariable logistic regression model. 283 consecutive patients with a mean age of 66 ± 8 years were included. We diagnosed bleeding complications in 41 (14.5%) of the patients. Significant rectoprostatic hematomas were found in 24 patients. Intra-rectal blood collections were observed in 16 patients and one patient showed bleeding in the urinary bladder. The volume of rectoprostatic hematomas was determined with a median of 7.5 ml (range 2-40 ml, IQR 11.25). We found no correlation between the presence of a rectoprostatic hematoma and malignant findings, patient position in biopsy, number of cores, age, prostate volume nor PSA density (p > 0.05). Rectoprostatic hematomas and rectal blood collections are rare complications after in-bore MR-guided prostate biopsy. MR imaging provides benefits not only for lesion detection in prostate biopsy but also for the control of bleeding complications, which can be overlooked in standard TRUS biopsy. Their significance in pain, erectile dysfunction, and urinary retention remains to be investigated.
磁共振成像可发现直肠前列腺血肿，这是前列腺活检的一种并发症。我们评估了根据磁共振成像记录的经腔内磁共振引导前列腺活检后临床无症状性出血的频率和大小。在这项回顾性观察性单中心研究中，对 2007 年至 2020 年间连续 283 例疑似前列腺癌患者的经腔内磁共振引导前列腺活检的介入图像记录进行了评估。使用多变量逻辑回归模型分析与患者特征的相关性。连续纳入 283 例平均年龄 66±8 岁的患者。我们诊断出 41 例（14.5%）患者有出血并发症。24 例患者存在明显的直肠前列腺血肿。16 例患者出现直肠内血液积聚，1 例患者出现膀胱出血。直肠前列腺血肿的体积中位数为 7.5ml（范围 2-40ml，IQR 11.25）。我们发现直肠前列腺血肿的存在与恶性发现、活检时患者的体位、活检针数、年龄、前列腺体积或 PSA 密度均无相关性（p＞0.05）。经腔内磁共振引导前列腺活检后，直肠前列腺血肿和直肠内血液积聚是罕见的并发症。磁共振成像不仅对前列腺活检中的病灶检测有益，而且对出血并发症的控制也有益，这些并发症在标准的经直肠超声引导活检中可能被忽视。它们在疼痛、勃起功能障碍和尿潴留中的意义仍有待研究。
