‘Moustache sign’ seen in multiparametric MR imaging of the prostate signifies the presence of bilateral symmetric oval-shaped areas of low signal intensity on T2-WI at the base of the prostate lateral to the opening of ejaculatory ducts (Figs. 1, 2). The clinical significance of this sign is that it can mimic cancer. These symmetric areas can show diffusion-restriction, early enhancement on dynamic contrast imaging, and wrongly categorized PIRADS 4/5 according to PIRADS v.2. The use of coronal T2-weighted sequence, sharp margins, and symmetric pattern can correctly score this pattern into 2/5, excluding the presence of cancer [1, 2].
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