Thursday, May 29, 2025

MRI prostate plain, and contrast, What is the Function of the Prostate?

1. What is the Function of the Prostate?

The prostate is a small gland (about the size of a walnut) located below the bladder in men and surrounds part of the urethra.

Main functions:

  • Produces seminal fluid: This fluid mixes with sperm from the testes to form semen.

  • Nourishes and protects sperm: The fluid from the prostate contains enzymes, zinc, and citric acid that support sperm function.

  • Aids ejaculation: During ejaculation, the prostate contracts to help propel semen into the urethra.

2. Why Do MRI Prostate Plain (Non-Contrast)?

Plain MRI of the prostate (also called non-contrast or multiparametric MRI) is used as a non-invasive diagnostic tool.

Reasons:

  • Evaluate prostate anatomy and size

  • Detect tumors: Especially suspicious areas that may indicate prostate cancer.

  • Assess lesions: Determine if a lesion is likely to be benign or malignant.

  • Guide biopsies: Helps target areas that need tissue sampling.

MRI prostate plain typically includes:

  • T2-weighted imaging: Excellent for viewing the prostate’s internal zones.

  • Diffusion-weighted imaging (DWI): Detects how water molecules move in tissue, helping find cancer.

  • Apparent diffusion coefficient (ADC): Quantifies DWI.

  • Sometimes, spectroscopic imaging.

Many centers prefer non-contrast multiparametric MRI (mpMRI) as the initial step for screening or evaluating prostate issues.

3. Why Do MRI Prostate With Contrast (Dynamic Contrast Enhanced MRI – DCE-MRI)?

MRI with contrast (using gadolinium-based agents) is done when:

  • Further clarification of a lesion is needed.

  • Higher suspicion of cancer is present.

  • Evaluating cancer spread (staging).

  • Checking vascularity of a lesion (cancers typically show early enhancement).

  • Monitoring after treatment (e.g., after surgery, radiotherapy).

Dynamic Contrast Enhanced (DCE) imaging helps:

  • Detect fast-enhancing areas (which may indicate aggressive tumors).

  • Improve PI-RADS scoring (used to assess prostate lesions).

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