Helmy Matathia Nuban

1061050157
 Tujuan

 Penelitian ini dilakukan untuk mengetahui apakah
CT heliks dapat mengungkap karsinoma dari prostat
yang terdeteksi pada biopsi transversal sonografi.
 
 Dilakukan pada 35 pasien:
 25 dengan terbukti kanker prostat (umur kisaran, 45-
72 tahun) -> (kelompok I)
 10 tanpa kanker terdeteksi pada biopsi (rentang usia,
50-65 tahun) -> (kelompok II).
 65-year-old man with normal findings on digital rectal examination and prostatespecific
antigen of 7.5 ng/mL. Helical CT scan of prostate shows normal appearance of peripheral
zone as band of hypodense tissue (arrows). Note usual appearance of symmetric,
contrast-enhanced nodules of hyperplastic tissue in central gland (H).


 68 tahun dengan temuan abnormal pada pemeriksaan dubur digital dan prostat-
antigen spesifik 10,5 ng / mL. Helical CT scan menunjukkan area kontras fokal abnormal
peningkatan di bagian tengah zona periferal kiri (panah).


 60-year-old man with positive digital rectal examination and prostate-specific
antigen of 6.5 ng/mL. Transrectal sonographically guided biopsy detected adenocarcinoma,
Gleason score of 6 in left apical portion of peripheral zone.

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 58-year-old man with abnormal findings on digital rectal examination and
prostate-specific antigen of 15 ng/mL. Helical CT shows extensive area of intense
abnormal contrast enhancement in posterior and left portion of peripheral zone (arrows)
(adenocarcinoma of prostate.

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 68-year-old man with positive findings on digital rectal examination and prostate-
specific antigen of 12 ng/mL. Transrectal sonographically guided biopsy detected
adenocarcinoma. Gleason score of 8 in right peripheral zone, and Gleason score of 7 in
left peripheral zone.

Helical CT shows focal area of contrast

Note abnormal contrast enhancement of
contiguous neurovascular bundle (arrow),
enhancement in right peripheral zone of
suggestive of tumor involvement, which
prostate (arrow).
was confirmed on transrectal MR imaging.
 58-year-old man with negative digital rectal examination and rising prostate-
specific antigen levels in last 3 years who had undergone three sets of transrectal
sonographically guided biopsies (including transitional zones) with negative
results. His recent prostate-specific antigen level was 18 ng/mL.

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 68-year-old man with abdominoperineal resection and prostate-specific
antigen level of 16 ng/mL. After helical CT of prostate that showed suspicious area
of abnormal contrast enhancement in mid portion of right peripheral zone,
transgluteal percutaneous biopsy of this suspicious area allowed detection of
adenocarcinoma with Gleason score of 6.


 63-year-old man who underwent abdominal and pelvic CT for staging non–
Hodgkin’s lymphoma. Helical CT of pelvis revealed abnormal contrast enhancement in
right peripheral zone of prostate with capsular bulging (arrows). Note adenopathy also in
inguinal regions (asterisks). Transrectal sonographically guided biopsy revealed adenocarcinoma
with Gleason score of 8 in both peripheral zones. Prostate-specific antigen


level (15 ng/mL) was then obtained.
 
 Dari Hasil penelitian disarankan bahwa CT heliks
prostat mungkin berguna dalam kelompok pasien
terpilih berikut ini:
 pasien dengan tingkat PSA meningkat dan negatif
biopsi;
 pasien dengan tingkat PSA meningkat
setelah reseksi abdominoperineal
 pasien dengan pemeriksaan pelvis CT rutin
di mana peningkatan kontras fokal yang abnormal
di zona perifer diamati.
 Hasil

 Helical CT mengungkapkan kanker pada 22 (88%) dari 25
pasien dengan terbukti prostat kanker. Transrectal
sonographically guided biopsi mendeteksi 102 situs kanker
di bagian periferal zona dan tiga di zona transisi pada 25
pasien ini. Helical CT terungkap secara akurat 59 situs
kanker perifer (58%) namun tidak mengungkapkan 43 lokasi
kanker (42%). Kontras tidak normal Peningkatan di zona
perifer yang tidak disebabkan oleh kanker terlihat pada 10%
dari lesi mencurigakan. Tiga situs kanker di zona transisi
tidak dapat dibedakan dari perubahan nodular jinak.
 Kesimpulan

 Kanker prostat terdeteksi pada biopsi transversal
sonografi muncul pada CT heliks prostat sebagai
daerah fokus atau diffuse dari peningkatan kontras
pada zona perifer Sebuah studi prospektif telah
dimulai untuk menentukan keakuratan, kepekaan,
dan spesifisitas.