Ressonância magnética da próstata: uma visão geral para o radiologista: [revisão]

O adenocarcinoma prostatico e o segundo tumor em incidencia e mortalidade dentre as neoplasias malignas masculinas. Para adequada programacao terapeutica e importante a distincao entre tumores confinados a prostata e aqueles com extensao extraprostatica. Diferentes estudos tem demonstrado que a ressonância magnetica da prostata com bobina endorretal auxilia no estadiamento local destes pacientes. Este artigo apresenta informacoes sobre a anatomia prostatica, o aspecto tumoral a ressonância magnetica, sinais de extensao tumoral extraprostatica e invasao de vesiculas seminais, sugestoes de protocolo, principios gerais e importância da espectroscopia de protons, do estudo perfusional e da difusao, indicacoes da ressonância magnetica na investigacao de recidiva pos-operatoria e pos-radioterapia, seu papel na deteccao de lesoes suspeitas em pacientes com suspeita clinico-laboratorial de adenocarcinoma prostatico, alem de apresentar os diagnosticos diferenciais e limitacoes do metodo. Prostate adenocarcinoma is the second tumor in incidence and mortality among malignant neoplasms in men. The differentiation between tumors confined to the organ and those with extraprostatic extension is critical for an appropriate therapeutic planning. Different studies have demonstrated that magnetic resonance imaging of the prostate with endorectal coil is useful in the local staging of these tumors. The present article presents information on the prostate gland anatomy, the tumor aspect at magnetic resonance imaging, specific signs of extracapsular extension and seminal vesicles invasion, protocol suggestions, general principles and relevance of proton spectroscopy, perfusion and diffusion imaging, role of magnetic resonance imaging in the postoperative and post-radiotherapy detection of local tumor recurrence, and also in the detection of lesions in patients with clinical/laboratory suspicion of prostate adenocarcinoma. Additionally, the present article describes differential diagnoses and limitations of the method.