Male 57 years old Reason: 57M with high risk prostate cancer, pre-operative imaging for surgical planning. PELVIS:PROSTATE:Prostate Size: 4.7 x 5.3 x 4.6 cmPeripheral Zone: The peripheral zone at the base, mid gland and apex, right greater than left, as well as much of the central gland is replaced by abnormal T2 hypointense signal which is also dark on the ADC map. A representative measurement of signal abnormality at the midline measures 4.7 x 4.5 cm.Central Gland: Please see above.Seminal Vesicles: There is loss of normal T2 hyperintense signal within the medial aspect of the seminal vesicles bilaterally and the appearance is suspicious for seminal vesicle invasion.Extracapsular Extension: The prostate gland is diffusely enlarged and abuts the anterior wall of the rectum at the apex. Rectal invasion is not excluded.BLADDER: Foley catheter within the bladder, deviated in course secondary to prostatic tumor invasion.LYMPH NODES: Enlarged right common iliac node measures 1.3 x 0.9 cm (series 1003, image 119). Additional subcentimeter pelvic side wall and mesorectal nodes are also noted. A reference right perirectal node measures 0.8 x 0.5 cm.BONES, SOFT TISSUES: Left hip prosthesis causes significant artifact which significantly limits evaluation of the left hemipelvis and the adjacent osseous structures. Enhancing right hip joint effusion is suspicious for right hip synovitis which is incompletely assessed on this nondedicated study.OTHER: No significant abnormality noted.
1.Signal abnormality replacing much of the normal prostate gland with suspicion for extracapsular extension and seminal vesicle invasion. Invasion of the anterior rectal wall is not excluded. Enlarged right common iliac lymph node and subcentimeter perirectal and pelvic sidewall lymph nodes are noted.2.Suspicion for right hip synovitis.