ARRS 2022 Abstracts


E1369. Benign Prostatic Hyperplasia: Post-Treatment MRI Findings
  1. Mark Greenhill; University of Arizona
  2. Patrick Evans; University of Arizona
  3. Erol Bozdogan; University of Arizona
  4. Sunchin Kim; University of Arizona
  5. Joel Funk; University of Arizona
  6. Hina Arif; University of Arizona
Benign prostatic hyperplasia (BPH) is a common condition affecting 80% of men by the age of 80 years, corresponding to the proliferation of epithelial, smooth muscular, and connective tissues within the prostatic transition zone. BPH can lead to lower urinary tract symptoms ranging from nocturia to acute renal failure secondary to obstructive uropathy due to external compression from the enlarged prostate on the surrounding urethra. Currently, there are multiple interventions that can be performed to mitigate and/or eliminate the symptoms of BPH. These include transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), holmium laser enucleation of the prostate (HoLEP), laser ablation, photoselective vaporization of the prostate (PVP), prostatic artery embolization (PAE), UroLift, and Rezum water vapor therapy. These procedures produce characteristic MRI appearances that differ based upon the procedure performed. Additionally, these procedures carry potential complications that also produce characteristic imaging appearances.

Educational Goals / Teaching Points
The purpose of this educational exhibit is to familiarize the radiologist with the postprocedural MRI appearance of the prostate following the aforementioned interventions and imaging appearance of potential complications that can be encountered.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
T2-weighted (T2W) images (including small FOV high-resolution images) provide exquisite details of a normal prostate gland in demonstrating normal zonal anatomy. Multiplanar T2W, high-resolution T2W (T2 SPACE), and post-contrast dynamic T1W sequences will be utilized to illustrate the post-procedural findings associated with the previously discussed interventions commonly utilized for the treatment of BPH as well as the imaging appearance of potential complications that can be encountered following these procedures.

Multiple interventions for the treatment of BPH exist, and these procedures are becoming increasingly common. MRI is more frequently utilized in the evaluation of the prostate than ever before. It is important for the radiologist to be aware of the common MRI findings of the prostate following these procedures to accurately and succinctly identify expected post-interventional changes and potential complications.