Defining Benign Prostatic Hyperplasia (BPH)
HIDEInteractive Transcript
0:00
Let's talk now about benign prostatic
0:01
hypertrophy on MRI, which can be subdivided
0:05
into individual types based on the
0:08
lobes or segments that are enlarged.
0:10
And that'll be a separate vignette.
0:12
Let's define BPH.
0:14
It is defined as a gland that is
0:16
25 cubic centimeters or greater.
0:21
For smaller glands, we may use
0:22
one technique to measure it.
0:24
For larger glands, another technique.
0:27
Let's summarize those techniques.
0:30
So I've got three.
0:33
Three-dimensional T2 Fast Spin Echo MRI images.
0:37
Here's an axial.
0:39
Here's the reconstructed sagittal.
0:41
And here's the reconstructed
0:42
coronal off the 3D axial.
0:45
So this was the original plane of acquisition.
0:48
I'm going to, at the mid-gland level, take
0:51
the transverse dimension of the gland.
0:53
Let's mark it here.
0:56
The anteroposterior dimension of the gland
0:58
at its widest portion, let's mark it here.
1:01
And the cranial caudate dimension of
1:03
the gland off the coronal projection,
1:05
which we'll mark right there.
1:07
The gland kind of comes in like this,
1:09
makes a little curve, and then goes down.
1:11
So we've got width, we've got AP
1:14
dimension, and we've got length.
1:18
So let's do the two types of calculations.
1:21
For glands that are a little bit bigger, how big?
1:25
Well, pretty big.
1:26
So that's more subjective.
1:28
A lot of people like to use length
1:31
times width times height, which we have
1:35
just measured for you, times pi over 6.
1:41
So that is known as the ellipsoid volume.
1:45
For glands that are a bit smaller, but
1:48
still enlarged, some people like to
1:50
use what's known as the bullet volume.
1:51
I'll call it B.
1:53
And that is basically the same thing.
1:55
Length times width times
1:57
height times 5 pi over 24.
2:07
You can actually measure on MRI the
2:11
overall gland volume and come up with a
2:14
severity of BPH based on absolute volume.
2:19
So glands that are say 55 to 75, pretty enlarged.
2:24
75 to 90, very enlarged.
2:28
Over 90, massively enlarged.
2:32
And again, a normal is 25
2:34
cubic centimeters and below.
2:36
The two measuring techniques, the ellipsoid
2:38
technique and the bullet technique.
2:42
This one for smaller glands,
2:44
this one for larger glands.
2:46
Benign prostatic hypertrophy.
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
© 2024 Medality. All Rights Reserved.