The application of magnetic resonance enhanced 3D STIR T2WI SPACE sequence in the display of the anatomical structure of the seminal tracts in adults

Objective To explore the feasibility and application value of magnetic resonance enhanced three dimensional T2WI turbo-spin-echo sequence with short-term inversion recovery and sampling perfection using different flip angle evolutions (3D STIR T2WI SPACE) sequence on the anatomical structure of seminal tracts in adults. Methods MRI data of 58 adult male patients in the MR room of Huadong Hospital affiliated to Fudan University from November 2016 to March 2019 were retrospectively collected, aged from 29 to 87 years, they were divided into younger age group (≤60 years old, 22 cases) and the older group (>60 years old, 36 cases). All patients underwent multiplanar reformation (MPR) and curved planar reformation (CPR) after the 3D Viewer thin-layer maximum intensity projection (MIP) of the Siemens Syngo Via data processing station in Germany. The three-dimensional MIP reconstruction maps of the coronal, transverse and sagittal planes were obtained using the 3D Viewer to perform thin layer MIP. The morphology, running detour, signal intensity and background inhibition of the ampulla of the vas deferens, the posterior peritoneal segment and the seminal vesicles, refer to the scores of the Oh-Oka team in Japan, and the ampulla of the vas deferens and the posterior peritoneum in the MPR axial position and CPR images were observed, respectively. Segment and seminal vesicles were scored for image quality. The Wilcoxon signed rank test was used to compare the image quality scores of the MPR axial position and CPR images in the ampulla of the vas deferens, the posterior peritoneum and the seminal vesicles. The independent Wilcoxon rank test for two independent samples was used to compare the image quality scores of CPR images in the young and old groups. The detection rate of prostate capsules was counted, and the diameters of the three small azimuths of the prostate, the transverse and the vector were measured by the 3D MIP reconstruction images obtained from the 3D Viewer. Results Among the 58 patients(116 sides), the image quality scores of the MPR axial and CPR images of the 3D STIR T2WI SPACE sequence in the peritoneal vas deferens, the vas deferens, and the seminal vesicles were 3(3, 3)and 2(2, 2), 2(2, 2) and 2(1, 2), 2(1, 2) and 2(1, 2) scores, respectively.The MPR axial position and CPR images were statistically different in the peritoneal segment of the vas deferens and the ampulla segment of the vas deferens (Z=10.232, 5.196, 2.000, all P values<0.05). The image quality scores of the CPR images of the posterior vas deferens, the vas deferens and the seminal vesicles in the 22 patients with low-grade and 36 elderly patients with low back pain were 2(1, 2) and 2(2, 2), 2(1, 2) and (2, 2), 1(1, 2) and 2(1, 2) scores, respectively. In the two age groups, the MR-enhanced 3D STIR T2WI SPACE sequence CPR images in the patients with lower back pain were statistically significant (Z=2.673, 2.249, 3.042, all P values<0.05) in the ampulla segment of the vas deferens and seminal vesicles. The 58 cases of abdominal pelvic magnetic resonance enhanced 3D STIR T2WI SPACE sequence of prostate utricle cysts detection rate of 27.58% (16/58), and prostate utricle cysts’size in coronal, transverse and sagittal planes were 5.35 (4.33, 6.88 )mm, 7.50 (5.90, 9.00)mm and 8.00 (6.43, 10.78) mm, respectively. Conclusions Magnetic resonance enhanced 3D STIR T2WI SPACE sequence can clearly show the seminal vesicles, vas deferens pelvic segment, posterior peritoneal segment and prostate utricle cysts. Fine structural anatomy can provide imaging reference for guiding clinical practice. Key words: Seminal tracts; Vas deferens; Anatomy; Magnetic resonance imaging; Imaging three-dimensional