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      Lesions of the Seminal Vesicles and their MRI Characteristics

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          Abstract

          Over the past few decades, MRI of the prostate has made great strides in improving cancer detection and is being embraced by more clinicians each day. This article aims to review the imaging characteristics of common and uncommon, but consequential lesions involving the seminal vesicles (SV), as seen predominantly on MRI. Many of these findings are seen incidentally during imaging of the prostate. Anatomy and embryology of the SV will be described which will help illustrate the associations of abnormalities seen. Congenital, infectious, neoplastic, and tumor mimics will be explored in detail, with discussion on clinical presentation and treatment strategies.

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          Most cited references44

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          Zinner's syndrome: an up-to-date review of the literature based on a clinical case.

          The authors made an up-to-date review of the literature concerning the management of Zinner's syndrome and evaluated a young patient with Zinner's syndrome who had presented with urinary and ejaculatory complaints. Physical examination and transrectal ultra-sonography showed a 7.0 cm right seminal vesicle cyst. Magnetic resonance imaging (MRI) confirmed the diagnosis of Zinner's syndrome. Oligoasthenoteratozoospermia was present at the two seminal analyses. Symptomatic improvement was achieved with conservative measures. Actually, the patient is still on a follow-up programme. The diagnosis is usually established at the age of increased sexual activity. Patients may be asymptomatic or present pain, irritative urinary or ejaculatory symptoms and infertility. MRI has proved to be the best imaging examination. Treatment should be adapted to symptoms, surveillance being the best option in the absence of clinical manifestations. Surgical approach may be adequate when conservative measures prove ineffective. Zinner's syndrome should be suspected if a male young patient presents with unilateral renal agenesis and pelvic complaints and has a supraprostatic mass on digital rectal examination. The initial approach should be medical, but invasive procedures may be the only way to solve the patient's complaints. Nowadays, laparoscopic and robotic techniques must replace the open surgical approach.
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            Imaging of the seminal vesicle and vas deferens.

            The seminal vesicle (SV) and vas deferens (VD) are ancillary but essential urogenital organs. Understanding their embryologic features and anatomy can be helpful in evaluating various disorders of these organs. Recently, cross-sectional imaging modalities, including ultrasonography, computed tomography, and magnetic resonance (MR) imaging, have been increasingly used for evaluation of the SV and VD. The development of these organs is closely related to that of urinary organs, including the kidneys and ureters. Frequently, unilateral SV agenesis is associated with renal agenesis, and bilateral SV or VD agenesis is associated with mutations of the cystic fibrosis gene. Congenital SV cysts are commonly associated with ipsilateral renal agenesis or dysgenesis. These congenital anomalies can be well evaluated with MR imaging. Inflammation, post-radiation therapy changes, and amyloidosis of the SV appear as diffuse wall thickening and may mimic tumor invasion by prostate cancer. Primary neoplasms involving the SV and VD are extremely rare, whereas secondary neoplasms are much more common. Carcinoma from the prostate, bladder, or rectum can directly invade the SV and VD. Typical MR imaging findings of such invasion include a low-signal-intensity mass on T2-weighted images or soft-tissue thickening in the SV or VD along with loss of normal architecture.
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              Centers for Disease Control and Prevention

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                Author and article information

                Journal
                J Clin Imaging Sci
                J Clin Imaging Sci
                JCIS
                Journal of Clinical Imaging Science
                Medknow Publications & Media Pvt Ltd (India )
                2156-7514
                2156-5597
                2014
                31 October 2014
                : 4
                : 61
                Affiliations
                [1]Department of Radiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
                [1 ]Department of Abdominal Radiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
                Author notes
                Address for correspondence: Dr. Sadhna Verma, Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street, Cincinnati, Ohio - 45219, USA. E-mail: drsadhnaverma@ 123456gmail.com
                Article
                JCIS-4-61
                10.4103/2156-7514.143734
                4229784
                25396077
                a66852fb-3dea-47e0-b3fd-c9ff667b6f51
                Copyright: © 2014 Reddy MN.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 02 August 2014
                : 12 September 2014
                Categories
                Review Article

                Radiology & Imaging
                mri seminal vesicles,prostate cancer,prostate mri,seminal vesicles
                Radiology & Imaging
                mri seminal vesicles, prostate cancer, prostate mri, seminal vesicles

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