Prostatic carcinoma: staging with MR imaging at 1.5 T

Magnetic resonance (MR) imaging was used to stage prostatic carcinoma in 81 patients with a proved diagnosis. MR imaging findings were correlated with histologic findings regarding the local extent of disease (37 patieNts) and the presence of nodal metastases (51 patients). Tumor nodules were detected in the peripheral zone (PZ) in 34 of 37 patients and were of low signal intensity compared with the signal of the PZ. Hemorrhage in the PZ represented a problem in tumor detection and in tumor volume measurement. When multiple criteria for local tumor spread were combined, MR imaging had a sensitivity of 72%, a specificity of 84%, and an accuracy of 78% in the differentiation of stage A or B from Stage C or D disease. Assessment of seminal vesicle invasion was more accurate than assessment of direct extracapsular spread. In five patients, microscopic invasion of the capsule (stage C) was classified as stage B with MR imaging; from a clinical standpoint, this should not affect patient treatment and prognosis. The MR imaging sensitivity in the detection of lymph node metastases was 69%, with a specificity of 95% and an accuracy of 88%. In this study MR imaging proved reliable in the comprehensive evaluation and staging of prostatic carcinoma.     

Femoral artery pseudoaneurysm: diagnosis with conventional duplex and color Doppler US

Three patients with clinically suspected pseudoaneurysm as a complication of femoral puncture were referred for ultrasound (US) evaluation with both conventional duplex Doppler US and color Doppler imaging. Pseudoaneurysm (n = 2) and simple hematoma (n = 2) were depicted with both Doppler systems, and a separate pseudoaneurysm and a hematoma were found in one patient. These diagnoses were confirmed surgically. Distinctive Doppler spectral waveforms and color Doppler findings enabled confident diagnoses. Color Doppler imaging allowed faster detection of intraaneurysmal flow, and the track between the injured artery and the pseudoaneurysm was identified only with color Doppler imaging. Duplex Doppler US with color Doppler imaging allows for the rapid, unequivocal diagnosis of pseudoaneurysm, thus enabling prompt treatment without the need for invasive diagnostic modalities.