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 in a patient with prostatitis shows edema of the prostate gland with diffuse enlargement, mostly in the peripheral zone. An abscess can also be identified as a rim enhancing hypodensity which can either be unilocular or multilocular. On ultrasonography,focal hypoechoic region located in the peripheral part of the prostate represents prostatitis. Fluid collection can show abscess formation. Colour Doppler ultrasound may also prove to be very effective. MRI is also an important investigation and depicts diffuse enlargement of the gland.[1][2]
Imaging findings
CT
When an abscess is included in the differential diagnosis of prostatitis, a contrast CT scan is preferred. CT scan in a patient with prostatitis shows edema of the prostate gland with diffuse enlargement, mostly in the peripheral zone. An abscess can also be identified as a rim enhancing hypodensity which can either be unilocular or multilocular. Central zone can be involved rarely such as after the transurethral resection of the prostate (TURP).[1][2][3]
Ultrasound
On ultrasonography, focal hypoechoic region located in the peripheral part of the prostate represents prostatitis. Fluid collection can show abscess formation. Colour Doppler ultrasound may also prove to be very effective.[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)