Imaging
Prostatitis
- Preliminary Diagnosis: Prostatitis
-
I. What imaging technique is first-line for this diagnosis?
- II. Describe the advantages and disadvantages of this technique for diagnosis prostatitis.
-
III. What are the contraindications for the first-line imaging technique?
-
IV. What alternative imaging techniques are available?
- V. Describe the advantages and disadvantages of the alternative techniques for diagnosing prostatitis.
- VI. What are the contraindications for the alternative imaging techniques?
Preliminary Diagnosis: Prostatitis
I. What imaging technique is first-line for this diagnosis?
Ultrasound of the prostate gland. Transrectal offers better imaging.
II. Describe the advantages and disadvantages of this technique for diagnosis prostatitis.
Advantages
Highly portable imaging modality.
Does not expose patients to ionizing radiation.
Exquisitely details the vascularity of the prostate gland.
May help guide percutaneous biopsy.
Disadvantages
Limited in sensitivity and specificity in detailing the prostate anatomy and surrounding soft tissues.
Prostatitis is more of a clinical diagnosis.
III. What are the contraindications for the first-line imaging technique?
No specific contraindications to ultrasound exist.
IV. What alternative imaging techniques are available?
CT imaging of the pelvis with contrast.
MR imaging of the pelvis with contrast.
V. Describe the advantages and disadvantages of the alternative techniques for diagnosing prostatitis.
CT imaging of the pelvis with contrast
Advantages
Highly details the surrounding soft tissues, vasculature, and osseous structures with great sensitivity and specificity.
Better evaluates for any secondary complications, i.e., abscess and hemorrhage, than other imaging modalities.
Disadvantages
Limited in detecting subtle inflammatory change seen in subtle prostatitis.
Exposes patients to ionizing radiation.
Prostatitis is more of a clinical diagnosis.
MR imaging of the pelvis with contrast
Advantages
Offers exquisite detail of the surrounding soft tissues and is able to detail subtle edema of the prostate gland noted in prostatitis.
Gold standard in detailing and characterizing the anatomy of the prostate gland and detecting any underlying inflammatory change.
Highly sensitive and specific in evaluating the primary pathology and evaluating and characterizing any secondary complications.
Disadvantages
May be subject to motion and susceptibility weighted artifact, degrading image quality.
Less exquisite in detailing the surrounding osseous structures.
Expensive.
Time consuming.
Prostatitis is more of clinical diagnosis.
VI. What are the contraindications for the alternative imaging techniques?
CT imaging of the pelvis with contrast
May be contraindicated in pregnant patients.
MR imaging of the pelvis with contrast
May be contraindicated in patients with non-MR compatible hardware.
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