Prostatitis imaging findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2]
Overview
CT scan will show a edematous gland enlarged diffusely, preferably involving the peripheral zone. An abscess can be seen as a hypodensity present in the peripheral zone of the prostate which is unilocular or multilocular and rim-enhancing. On ultrasound, prostatitis can present as a focal hypoechoic region in the peripheral zone of the gland. Collection of fluid with clear boudoirs may suggest the formation of an abscess. Colour Doppler ultrasound can also be very helpful. The diffusely enlarged prostate can be seen on MRI.[1][2]
Imaging findings
CT
Contrast enhanced CT is the preferred imaging study in case an abscess is suspected. CT scan will show a edematous gland enlarged diffusely, preferably involving the peripheral zone. An abscess can be seen as a hypodensity present in the peripheral zone of the prostate which is unilocular or multilocular and rim-enhancing. Central zone can be involved in some cases e.g after the transurethral resection of the prostate (TURP).[1][2][3]
Ultrasound
On ultrasound, prostatitis can present as a focal hypoechoic region in the peripheral zone of the gland. Collection of fluid with clear boudoirs may suggest the formation of an abscess. Colour Doppler ultrasound can be done and may show increase flow in abscess particularly in the periphery.[1]
MRI
The diffusely enlarged prostate can be seen on MRI. It is usually accompanied by inflammatory modifications of the fat around the prostate and the seminal vesicles. It has been shown that combining the morphology with the conventional MRI investigation can be more effective in differentiating prostatitis from early peripheral prostatic carcinoma.[1][4][5]
Findings of acute prostatitis on MRI include:
- T1: peripheral zone iso- or hypo-intense to transitional zone
- T2: hyperintense
- Gd (C+): diffusely enhancing
Prostate Imaging Reporting and Data System
Prostate Imaging reporting and Data System or PIRADS score is very helpful in diagnosing prostatitis and differentiating it from prostatic cancer.
- A higher PIRADS score can differentiate prostatic inflammation from carcinoma more reliably.[6]
References
- ↑ 1.0 1.1 1.2 1.3 Prostatitis. Radiopaedia 2016. http://radiopaedia.org/articles/prostatitis. Accessed on Feb 09, 2017
- ↑ 2.0 2.1 Sharp VJ, Takacs EB, Powell CR (2010). "Prostatitis: diagnosis and treatment". Am Fam Physician. 82 (4): 397–406. PMID 20704171.
- ↑ Robert Lucaj & Dwight M. Achong (2017). "Concurrent Diffuse Pyelonephritis and Prostatitis: Discordant Findings on Sequential FDG PET/CT and 67Ga SPECT/CT Imaging". Clinical nuclear medicine. 42 (1): 73–75. doi:10.1097/RLU.0000000000001415. PMID 27824318. Unknown parameter
|month=ignored (help) - ↑ Rajeev Jyoti, Noel Hamesh Jina & Hodo Z. Haxhimolla (2016). "In-gantry MRI guided prostate biopsy diagnosis of prostatitis and its relationship with PIRADS V.2 based score". Journal of medical imaging and radiation oncology. doi:10.1111/1754-9485.12555. PMID 27987276. Unknown parameter
|month=ignored (help) - ↑ P. Li, Y. Huang, Y. Li, L. Cai, G. H. Ji, Y. Zheng & Z. Q. Chen (2016). "[Application evaluation of multi-parametric MRI in the diagnosis and differential diagnosis of early prostate cancer and prostatitis]". Zhonghua yi xue za zhi. 96 (37): 2973–2977. PMID 27760657. Unknown parameter
|month=ignored (help) - ↑ Rajeev Jyoti, Noel Hamesh Jina & Hodo Z. Haxhimolla (2016). "In-gantry MRI guided prostate biopsy diagnosis of prostatitis and its relationship with PIRADS V.2 based score". Journal of medical imaging and radiation oncology. doi:10.1111/1754-9485.12555. PMID 27987276. Unknown parameter
|month=ignored (help)