Case Challenge

Genitourinary (GU)

Prostate/seminal vesicles

Stephen J Pomeranz

Gain confidence interpreting Prostate MRI Cases with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME!

Case Review

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Post-Course Activities

This Power Pack is comprised of 75 unique Prostate MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Prostate MRI Cases

Case 74 - 59-year-old male presents with elevated PSA level 5.85ng/mL

<div>HISTORY:&#160;This 59-year-old male presents with elevated PSA level 5.85ng/mL one year prior.&#160;Negative biopsy nine years prior.&#160;No surgery.&#160;No cancer.PRIMARY FINDING:&#160;PI-RADS 2 of 5.FINDINGS:&#160;The prostate gland measures 3.6cm in CC, 3.7cm in AP, and 5.2cm in transverse dimensions.&#160;Calculated prostate volume is 56.4cc and PSA density is 0.10ng/mL/cc.&#160;Transitional zone hyperplasia is present.&#160;No suspicious T2 hypointense area with diffusion restriction to suggest malignant neoplastic process in the peripheral or transitional zones.&#160;Anatomical prostate capsule, bilateral neurovascular bundles and seminal vesicles are clear.&#160;Urinary bladder is partially full and unremarkable.&#160;Indentation of the enlarged transitional zone to urinary bladder floor is noted.&#160;Rectal wall is intact.&#160;Rectoprostatic fat planes are preserved.&#160;Substantive generalized decreased T2 signal in the peripheral zone without diffusion restriction is most consistent with fibrotic changes and scarring.&#160;No enlarged lymph nodes in the pelvis or inguinal regions.&#160;Iliac arteries and veins are widely patent at the visualized aspects.&#160;Mild capsulitis of bilateral hip joints noted.&#160;Otherwise, the musculoskeletal structures are within normal limits.&#160;CONCLUSION:&#160;1. PI-RADS 2 of 5, benign hyperplasia of the transitional zone.&#160;2. Scarring in the peripheral zone of the prostate gland.&#160;3. Mild capsulitis of bilateral hip joints.</div>

Case

Under which PI-RADS score would this case most likely be classified?