RESUMO
RATIONALE AND OBJECTIVES: To evaluate interobserver agreement of Prostate Imaging Reporting and Data System (PI-RADS) v2 category among radiologists with different levels of experience. The secondary objective was to evaluate the positivity for significant cancer among each category (splitting category 4 into two) and among different lesion sizes. MATERIALS AND METHODS: Institutional review board and ethics comitee approved retrospective study. Eight radiologists with different levels of experienced in prostatic magnetic resonance imaging-two more experienced, four with intermediate experience, and two abdominal radiology fellows-interpreted 160 lesions. Reference standard was fusion-targeted biopsy. Percentage agreement, k coefficients, and analysis concordance were used. RESULTS: Coefficient of concordance according to categories was 0.71 considering both zones, 0.72 for peripheral zone (PZ) and 0.44 for peripheral zone (TZ). Agreement for PI-RADS score of 3 or greater was 0.48 in PZ and 0.57 in TZ. Tumor positivity rates were 54.3% and 66.0% for PI-RADS 3â¯+â¯1 and 4 for PZ, respectively; and 25.0 and 49.2% for PI-RADS 3â¯+â¯1 and 4 for TZ, respectively (p < 0.001 in both analysis). Lesions <10, 10-14, and ≥15 mm had 55.3%, 74.6%, and 93.5% of positivity rates for cancer in PZ (pâ¯=â¯0.002 and <0.001) and 26.7%, 56.5%, and 59.6% in TZ, respectively (pâ¯=â¯0.245 and 0.632). Sensitivities, specificities, and accuracies of magnetic resonance imaging for prostate cancer using PI-RADS v2 were 76%, 72%, and 74% for PZ; and 76%, 69%, and 71% for TZ, respectively. CONCLUSION: This study shows that PI-RADS v2 has overall good interobserver agreement among radiologists with different levels of experience. PI-RADS category 3â¯+â¯1 showed lower positivity rates for significant cancer compared to category 4. Lastly, lesions 10-14 mm has similar positivity rates compared to ≥15 mm for TZ lesions.
Assuntos
Competência Clínica , Interpretação de Imagem Assistida por Computador/métodos , Biópsia Guiada por Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Radiologistas/normas , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
ABSTRACT Tuberculous prostatitis is a rare and often overlooked entity that may mimic prostatic adenocarcinoma on imaging exams, especially multiparametric magnetic resonance imaging (MRI) of the prostate. Detection of a prostatic abscess is a clue to the correct diagnosis.
Assuntos
Humanos , Masculino , Idoso , Neoplasias da Próstata/diagnóstico , Prostatite/diagnóstico , Tuberculose dos Genitais Masculinos/diagnóstico , Adenocarcinoma/diagnóstico , Abscesso/diagnóstico , Prostatite/complicações , Tuberculose dos Genitais Masculinos/complicações , Imageamento por Ressonância Magnética , Achados Incidentais , Diagnóstico Diferencial , Abscesso/microbiologiaAssuntos
Abscesso/diagnóstico , Adenocarcinoma/diagnóstico , Neoplasias da Próstata/diagnóstico , Prostatite/diagnóstico , Tuberculose dos Genitais Masculinos/diagnóstico , Abscesso/microbiologia , Idoso , Diagnóstico Diferencial , Humanos , Achados Incidentais , Imageamento por Ressonância Magnética , Masculino , Prostatite/complicações , Tuberculose dos Genitais Masculinos/complicaçõesAssuntos
Humanos , Masculino , Pessoa de Meia-Idade , Fígado Gorduroso/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Pessoa de Meia-IdadeRESUMO
Corkscrew esophagus (also referred as rosary bead esophagus) is a classic finding of diffuse esophageal spasm (DES) in barium studies reflecting abnormal contractions, leading to compartmentalization and curling of the esophagus, ultimately giving an appearance similar to a corkscrew or rosary beads. We review the pathophysiology of this finding, correlating it to corkscrew and rosary images that originated this classic description.
