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Subdividing the Prostate Zones in the Axial Plane

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Let's talk about the axial

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zonal anatomy of the prostate.

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Now this is, this is not for show.

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This is for go.

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So, you're gonna, you're gonna use and

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play with this zonal anatomy description

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when you are looking at masses.

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So let's begin with the easy one,

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the anterior fibromuscular stroma.

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It's got a name, uh, it's got an

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abbreviated name called the AS.

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And you'll, you'll use a designation

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of, say, right AS or left AS.

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And that's not an official designation, but

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I like to tell the clinician whether I'm on

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the right side or left side of the gland.

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So I'll add that in.

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But AS is a well-accepted abbreviation.

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Then you've got this, this orange area.

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I think we better go to another color.

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And I'm gonna try something

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like, uh, deep blue here.

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And we are in the transitional

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zone, otherwise known as the TZ.

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So you've got a right TZ and a left TZ once

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again, and the TZ has the abbreviation,

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TZ A for anterior and TZ, P for posterior,

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and it's gonna be on both sides.

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Now we got it on the left

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side, so go right and left.

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TZA and TZP.

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So you can split it right down the middle

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between the anterior and the posterior.

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So that's pretty simple.

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The transitional zone, or TZ, and

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this yellow area, the central zone,

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or CZ, make up the central gland.

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So the CZ is very easy.

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It only has one simple name.

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We use something like brown.

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Now, as you get a little bit older, the

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CZ, and even the TZ, which exists around

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the urethra and periurethral tissue may get

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a little bit bigger and globular and kind

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of start to press against this brown area

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in the back, which is the peripheral zone.

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So you may kind of blot out this, this

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edge, posterior edge of the peripheral

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zone when you have hypertrophy.

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Now let's move on to the PZ, which is where 70

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percent of all the cancers are going to be found.

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And I'm going to use something

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like a light blue here.

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And you've got a PZA.

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You've got a PZP and you're gonna have a,

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a set of right ones and a set of left ones.

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Pretty simple.

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And then we add to that a PZM.

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You've got a PZM on the right and a PZM

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on the left, which kind of stands for Pial.

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And then again, these, these can be kind of

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pressed out of the way, so these may be a

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little bit smaller and harder to identify.

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We're going to correlate these, these zonal

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areas in other projections, so, so have no fear.

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And they're going to look a little different.

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The amounts of each are going to vary whether

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you're at the apex or whether you're at the base.

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So, sorry, whether you're at the base

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or whether you're at the apex down low.

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Now, the central zone, as you get down

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low, it's gonna, it's gonna fade away.

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So that's, that's an easy thing to remember.

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I've also drawn in the ejaculatory ducts,

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which exist in the CZ, or central zone.

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And then you've got the all-important

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neurovascular bundle, which is

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seen at 5 o'clock and 7 o'clock.

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And this is gonna be surrounded

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by T1, hyperintense fat.

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That's the zonal anatomic description you're

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going to use in your localization of masses

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in the prostate in the axial projection.

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Basic, basic.

Report

Editorial Note

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

John F. Feller, MD

Chief Medical Officer, HALO Diagnostics. Medical Director & Founder, Desert Medical Imaging. Chief of Radiology, American Medical Center, Shanghai, China.

HALO Diagnostics

Tags

Prostate/seminal vesicles

Neoplastic

MRI

Genitourinary (GU)

Body

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