Color and power Doppler images can also be acquired, particularly when prostate cancer is suspected and prostatic biopsy is contemplated [2,8]. TRUS-guided aspiration or biopsy of the seminal vesicles or prostate gland can be performed to further elucidate the site of bleeding, to provide a definitive diagnosis if a lesion is detected, or to confirm the presence of ejaculatory duct obstruction [4,15]. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Hematospermia Magnetic resonance imaging Magnetic resonance imaging (MRI), with its excellent soft-tissue contrast, provides radiation-free, multiplanar, high-spatial-resolution anatomic evaluation of the prostate gland and seminal tract. Imaging should be performed at either 1.5T or 3T, although there is no consensus at this time on the appropriate coil selection or field strength. The fundamental advantage of 3T over 1.5T is increased signal-to-noise ratio, which improves the spatial, temporal, and spectral resolution. Comparable performance between multichannel phased array coil MRI of the prostate at 3T and endorectal phased array coil MRI at 1.5T has been reported [20]. As opposed to TRUS, MRI is operator independent and can be performed when TRUS is unsatisfactory or nondiagnostic. Subsequently, small field-of-view axial T1-weighted images and axial, sagittal, and coronal T2-weighted images are obtained for high- resolution evaluation of the prostate gland, seminal vesicles, ejaculatory ducts, and ampullary portions of the vasa deferentia, followed by large field-of-view images to evaluate for pelvic lymphadenopathy [3,7,10,21].
Hematospermia. Color and power Doppler images can also be acquired, particularly when prostate cancer is suspected and prostatic biopsy is contemplated [2,8]. TRUS-guided aspiration or biopsy of the seminal vesicles or prostate gland can be performed to further elucidate the site of bleeding, to provide a definitive diagnosis if a lesion is detected, or to confirm the presence of ejaculatory duct obstruction [4,15]. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Hematospermia Magnetic resonance imaging Magnetic resonance imaging (MRI), with its excellent soft-tissue contrast, provides radiation-free, multiplanar, high-spatial-resolution anatomic evaluation of the prostate gland and seminal tract. Imaging should be performed at either 1.5T or 3T, although there is no consensus at this time on the appropriate coil selection or field strength. The fundamental advantage of 3T over 1.5T is increased signal-to-noise ratio, which improves the spatial, temporal, and spectral resolution. Comparable performance between multichannel phased array coil MRI of the prostate at 3T and endorectal phased array coil MRI at 1.5T has been reported [20]. As opposed to TRUS, MRI is operator independent and can be performed when TRUS is unsatisfactory or nondiagnostic. Subsequently, small field-of-view axial T1-weighted images and axial, sagittal, and coronal T2-weighted images are obtained for high- resolution evaluation of the prostate gland, seminal vesicles, ejaculatory ducts, and ampullary portions of the vasa deferentia, followed by large field-of-view images to evaluate for pelvic lymphadenopathy [3,7,10,21].