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Prostate, coronal, planar anatomy.

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I've taken a representative section.

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Although remember, the anatomy is going

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to vary a bit as you go from front to back

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because in the back of the gland you're

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going to have mostly peripheral zone.

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And you're going to appreciate that when we

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look at a live example of a prostate on MRI.

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But let's begin.

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We've got the transitional

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zone, which is periurethral.

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We've got the urethra and the periurethral tissue.

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And the transitional zone is seen here in yellow.

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Now the transitional zone, as you,

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as you age, is going to get bigger,

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and it often has sort of a globular look to it.

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You know, it expands much like this.

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Almost like two half bowling balls,

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or two bowling balls on each side.

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So it's going to get bigger,

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and as it gets bigger, it's going to start

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to press into the periurethral tissue.

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The central zone and press

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into the peripheral zone.

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The same thing is true of the central zone.

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The central zone is labeled here in orange.

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So let's do something to the central zone.

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Let's make the orange area

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a little bit bigger too.

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So as you age, that's going to get bigger as well.

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And that's also going to press

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into the upper lateral portion.

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peripheral zone.

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Now the peripheral zone is seen here in, in brown.

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You can see it's a pretty large structure.

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What makes MR so valuable though, is not, is

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not seeing this area, but it's seeing this

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area down low, which is so hard to analyze.

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My physical exam, and even by visual inspection

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and biopsy, it's just a hard area to get to.

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And a lot of cancers occur down here.

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Most radiologists don't think to look down here.

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And also anterior in this area is where

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the fibromuscular zone is located.

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Which is dark, and cancers are dark.

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So you have to kind of really tease out

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what's normal tissue and what's cancer.

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And you use the diffusion image, uh, to do that.

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I'm not going to talk about the actual zones.

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If you go to the axial vignette, it'll give you

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the zonal abbreviations for a lot of these areas.

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And I do my zone mapping or

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descriptors in my dictation.

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almost always off the axial projection.

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We also have the seminal vesicles, which are

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secretory glands that contain proteinaceous

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fluid, although they may be desiccated,

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they vary in their signal intensity.

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We've got the ejaculatory ducts or ductus

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deferens, and then two other important structures.

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The margin between the central gland,

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remember the central gland, consists of

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the central zone and the transitional zone.

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So all this is central gland.

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It is separated from the peripheral

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zone by something called, seen here

2:52

in white, the surgical capsule.

2:55

That is really important.

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Because when you have a cancer in the central

3:00

gland, it is often a thick lentiform structure,

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I'll make it black, it's kind of charcoal like.

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As opposed to, say, a nodule, which is round, and

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usually the round, well defined nodules, most of

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the time, in the central gland are benign, but the

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charcoal like lentiform abnormalities are not, and

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they will subtly cross over the surgical capsule.

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And then you have the peripheral

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anatomic capsule, which is the outside

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of the gland, and what's around that?

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Oh, lots of little vessels.

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The, the The perivenous plexus, or the

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periprostatic plexus, is located around here.

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And you saw in the axial vignette

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that you got the neurovascular bundle

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posterolateral at 5 and 7 o'clock.

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So that's our coronal basic basic

3:57

diagram of the prostate gland.

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Remember how important the surgical capsule is.

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Differentiate it from the anatomic capsule.

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And remember that there's going to be some change

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as you go from 30 years old to 80 years old in

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the amount of central gland tissue that's there.

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It's almost always going to

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be bigger as you get older.