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Relationship of Seminal Megavesicles, Prostate Median Cysts, and Genotype in Autosomal Dominant Polycystic Kidney Disease
Author(s) -
Zhang Weiguo,
Stephens Chelsea J.,
Blumenfeld Jon D.,
Behzadi Ashkan Heshmatzadeh,
Donahue Stephanie,
Bobb Warren O.,
Newhouse Jeffrey H.,
Rennert Hanna,
Zhao Yize,
Prince Martin R.
Publication year - 2019
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.26289
Subject(s) - pkd1 , autosomal dominant polycystic kidney disease , prostate , medicine , cyst , seminal vesicle , urology , polycystic kidney disease , kidney disease , ejaculatory duct , kidney , prostate cancer , pathology , gastroenterology , endocrinology , cancer
Background Autosomal dominant polycystic kidney disease (ADPKD) can involve prostate and seminal vesicles but the potential interrelationship of these findings and associations with PKD gene mutation locus and type is unknown. Purpose To determine the interrelationship of seminal megavesicles (seminal vesicles with lumen diameter > 10mm) and prostatic cysts in ADPKD and to determine whether there are associations with PKD gene mutations. Study Type Retrospective, case control. Population Male ADPKD subjects ( n = 92) with mutations in PKD1 ( n = 71; 77%) or PKD2 ( n = 21; 23%), and age/gender‐matched controls without ADPKD ( n = 92). Field Strength/Sequence 1.5T, axial/coronal T 2 ‐weighted MR images. Assessment Reviewers blinded to genotype independently measured seminal vesicle lumen diameter and prevalence of cysts in prostate, kidney, and liver. Statistical Tests Nonparametric tests for group comparisons and univariate and multivariable logistic regression analyses to identify associations of megavesicles and prostate median cysts with mutations and renal/hepatic cyst burden. Results Seminal megavesicles were found in 23 of 92 ADPKD (25%) subjects with PKD1 (22/71, 31%) or PKD2 ( n = 1/21, 5%) mutations, but in only two control subjects ( P < 0.0001). Prostate median cysts were found in 17/92 (18%) ADPKD subjects, compared with only 6/92 (7%) controls ( P = 0.01), and were correlated with seminal vesicle diameters (ρ = 0.24, P = 0.02). Nonmedian prostate cyst prevalence was identical between ADPKD and controls (7/92, 8%). After adjusting for age, estimated glomerular filtration rate, and height‐adjusted total kidney volume, ADPKD subjects with megavesicles were 10 times more likely to have a PKD1 than a PKD2 mutation. Among PKD1 subjects, seminal megavesicles occurred more frequently with nontruncating mutations with less severe kidney involvement. Data Conclusion ADPKD is associated with prostate median cysts near ejaculatory ducts. These cysts correlate with seminal megavesicles (dilated to >10 mm) which predict a 10‐fold greater likelihood of PKD1 vs. PKD2 mutation. Cysts elsewhere in the prostate are not related to ADPKD. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:894–903.