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

Findings of prostatitis on CT include a diffusely enlarged, edematous gland with predilection for peripheral zone involvement. When an abscess is present it is seen as a rim-enhancing, unilocular or multilocular, hypodensity in the peripheral zone. On ultrasound, prostatitis is characterized by a focal hypoechoic region in the peripheral zone of the gland. Discrete fluid collection suggests abscess formation. Colour Doppler ultrasound demonstrates increase flow in the periphery of the abscess. On MRI, the prostate will be diffusely enlarged, often with associated inflammatory changes of periprostatic fat and of the seminal vesicles.

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).

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.

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.

Findings of acute prostatitis on MRI include:

• T1: peripheral zone iso- or hypo-intense to transitional zone
• T2: hyperintense
• Gd (C+): diffusely enhancing