Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Radiology Unit, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
Eur J Radiol. 2023 Sep;166:110984. doi: 10.1016/j.ejrad.2023.110984. Epub 2023 Jul 18.
The role of multiparametric MRI (mpMRI) in prostate cancer setting is increasingly consolidated and, as a result, its usage in clinical practice is in exponential growth. However, beyond the prostate gland, several key structures are included in the field of view of mpMRI scans. Consequently, various extra-prostatic incidental findings (IFs) belonging to different anatomical systems can be accidentally recognized. Therefore, it is mandatory for a radiologist to be familiar with the wide range of pathologies potentially encountered, to guide management and avoid patient anxiety and costs due to additional work-up prompted by clinically insignificant extra-prostatic findings. With this pictorial review, we aim to illustrate a wide range of IFs that can be detected when performing mpMRI of the prostate, focusing on their imaging characteristics, differential diagnosis, and clinical relevance. Additionally, we propose the CheckDEEP, the Checklist for DEtection of ExtraProstatic findings, to be used for a thorough evaluation of target areas within each anatomical system.
多参数 MRI(mpMRI)在前列腺癌中的作用日益巩固,因此其在临床实践中的应用呈指数级增长。然而,除了前列腺之外,mpMRI 扫描的视野中还包括几个关键结构。因此,可能偶然识别到不同解剖系统的各种前列腺外偶然发现(IFs)。因此,放射科医生必须熟悉可能遇到的广泛病理,以指导管理并避免因临床意义不大的前列腺外发现而导致的额外检查引起的患者焦虑和费用。通过本影像学综述,我们旨在说明在进行前列腺 mpMRI 时可以检测到的广泛的 IFs,重点介绍它们的影像学特征、鉴别诊断和临床相关性。此外,我们提出了 CheckDEEP,即 ExtraProstatic 发现检测的检查表,用于对每个解剖系统内的目标区域进行彻底评估。