0:00

Let's look at an example of the anterior

0:03

form of BPH, so-called lobar type 1.

0:08

Type 1 in the front, type 2 posterosuperior

0:11

in the back behind the urethra,

0:14

type 3 balanced, both hypertrophied equally,

0:17

and type 4 pedunculated masses often arising in

0:21

the periurethral region, prolapsing into

0:25

and compressing the urethra would be a type 4.

0:27

So this is a type 1.

0:29

Most of the gland that's enlarged

0:32

is in front of the urethra.

0:34

So where is the urethra, you might ask?

0:37

It's a little hard to see,

0:38

but there's the opening right there.

0:40

And this dark slit represents the upper

0:43

portion of the urethra that has no

0:45

fluid in it because it's compressed.

0:48

In the axial projection, you can often

0:50

find urethra in front of the veru

0:53

montanum and the prostatic utricle.

0:55

So here's the utricle, the great landmark,

0:58

the smooth muscle, dark area in front of it is the

1:00

veru montanum, not a big one, and then the

1:04

little dot in front of that is the urethra.

1:06

So where's the urethra?

1:08

Back here.

1:09

So now you know that most of the gland that's

1:11

enlarged is in front of the urethra, only a little

1:16

bit of the gland that's big is behind the urethra.

1:19

The urethra is right there, this dark

1:22

irregular crack, and so this would

1:25

be a type 1 lobar hypertrophy.

1:29

And then you would go on to measure length

1:31

times width times height, and then pick

1:34

whether you're going to use the ellipsoid

1:35

or bullet technique to calculate the

1:37

volume of this prostate, which is pretty big.

Lobar Type 1

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0:00

Let's look at an example of the anterior

0:03

form of BPH, so-called lobar type 1.

0:08

Type 1 in the front, type 2 posterosuperior

0:11

in the back behind the urethra,

0:14

type 3 balanced, both hypertrophied equally,

0:17

and type 4 pedunculated masses often arising in

0:21

the periurethral region, prolapsing into

0:25

and compressing the urethra would be a type 4.

0:27

So this is a type 1.

0:29

Most of the gland that's enlarged

0:32

is in front of the urethra.

0:34

So where is the urethra, you might ask?

0:37

It's a little hard to see,

0:38

but there's the opening right there.

0:40

And this dark slit represents the upper

0:43

portion of the urethra that has no

0:45

fluid in it because it's compressed.

0:48

In the axial projection, you can often

0:50

find urethra in front of the veru

0:53

montanum and the prostatic utricle.

0:55

So here's the utricle, the great landmark,

0:58

the smooth muscle, dark area in front of it is the

1:00

veru montanum, not a big one, and then the

1:04

little dot in front of that is the urethra.

1:06

So where's the urethra?

1:08

Back here.

1:09

So now you know that most of the gland that's

1:11

enlarged is in front of the urethra, only a little

1:16

bit of the gland that's big is behind the urethra.

1:19

The urethra is right there, this dark

1:22

irregular crack, and so this would

1:25

be a type 1 lobar hypertrophy.

1:29

And then you would go on to measure length

1:31

times width times height, and then pick

1:34

whether you're going to use the ellipsoid

1:35

or bullet technique to calculate the

1:37

volume of this prostate, which is pretty big.

Report

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Lesson

MRI Mastery Series: Prostate Pre-Course Activities

Lesson

Introduction

Lesson

Prostate Anatomy

Lesson

Prostate Assessment & Scoring

Lesson

Evaluating BPH

Lesson

Case Review

Lobar Type 1