前列腺癌是男性全球第二常见的诊断癌症，也是男性致癌死亡的第五大原因。因此，早期和准确的诊断和分期至关重要。传统分期是基于临床评分，但效果低于前列腺多参数磁共振成像（mpMRI）。由于肿瘤分期是风险分层、预后和治疗决策的基础，mpMRI的主要目标是区分脏器限制性和局部晚期疾病。因此，这种成像技术已成为前列腺癌局部分期的最佳选择，对评估盆腔淋巴结疾病和骨骼受累具有递增价值，并提供有关准确位置和疾病扩展的补充信息。根据前列腺成像报告与数据系统v2.1指南，全面准确的mpMRI需要多个关键序列，包括T1加权成像（T1WI）和T2加权成像（T2WI）进行形态学评估，其中T2WI是局部分期的基石。此外，扩散加权成像（DWI）和经静脉注射顺磁性对比剂（DCE）所获得的动态序列是关键组成部分。值得注意的是，虽然MRI具有高特异性，但其在诊断外包膜扩展、精囊浸润和淋巴结转移方面的敏感性有限。此外，mpMRI也有其局限性，对于检测远处转移或评估淋巴结而言效果不如扩大盆腔淋巴结清扫术。本综述旨在强调mpMRI在前列腺癌分期中的重要性，并提供评估外包膜扩展、精囊浸润以及邻近器官和淋巴结受累的实际方法。©2023 作者发表。由IMR Press出版。

Prostate cancer ranks as the second most frequently diagnosed cancer globally among men and stands as the fifth leading cause of cancer-related death in males. Hence, an early and precise diagnosis and staging are critical. Traditional staging is based on clinical nomograms but presents a lower performance than prostate multiparametric magnetic resonance imaging (mpMRI). Since tumor staging serves as the basis for risk stratification, prognosis, and treatment decision-making, the primary objective of mpMRI is to distinguish between organ-confined and locally advanced diseases. Therefore, this imaging modality has emerged as the optimal selection for the local staging of prostate cancer, offering incremental value in evaluating pelvic nodal disease and bone involvement, and supplying supplementary insights regarding the precise location and disease extension. As per the Prostate Imaging Reporting & Data System v2.1 guideline, a comprehensive and accurate mpMRI requires several key sequences, which include T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) for morphological assessment, with T2WI serving as the cornerstone for local staging. Additionally, diffusion-weighted imaging (DWI) and dynamic sequences acquired with intravenous administration of paramagnetic contrast medium (DCE) are crucial components. It is worth noting that while MRI exhibits high specificity, its sensitivity in diagnosing extracapsular extension, seminal vesicle invasion, and lymph node metastases is limited. Moreover, mpMRI has its own constraints and is not as effective in detecting distant metastases or evaluating lymph nodes, for which extended pelvic lymph node dissection remains the gold standard. This review aims to highlight the significance of mpMRI in prostate cancer staging and provide a practical approach to assessing extracapsular extension, seminal vesicle invasions, and the involvement of adjacent organs and lymph nodes.© 2023 The Author(s). Published by IMR Press.