ABSTRACT
Objective To analyze the multimodal imaging findings of nonspecific granulomatous prostatitis (NSGP)and improve our understanding of the disease.Methods 1 427 patients underwent transrectal ultrasoundGguided prostate biopsies in our department,then 1 3 nodules in 11 patients were proven NSGP by pathology,of which 3 nodules were in inner gland and 10 were in outer gland.The characteristics of these nodules on MRI,transrectal ultrasound elastography (TRE)and contrastGenhanced ultrasonography (CEUS)were retrospectively analyzed. Results MRI:All of the nodules showed similar performances:hypointensity on T1 WI and T2 WI,low ADC and high signal on DWI (highGbGvalue),early enhancement and faded fast or slow,depressed citrate (Cit)and relatively elevated choline (Cho)peak.TRE:The cutGoff point of strain ratio (SR)was determined as 5.97 to diagnose prostate cancer and the SRs of 8 nodules were greater than 5.9 7.CEUS:1 1 nodules showed early enhancement and great intensity,but the rest of nodules showed same performance with normal tissue.Conclusion The multimodal imaging helps to improve the understanding of NSGP and plays a positive role in guiding targeted biopsy.Moreover,the operators could lessen the number of needle punctures properly according to the multimodal imaging findings, which would reduce the risk of puncture complications on patients.
ABSTRACT
Granulomatous prostatitis is an infrequently seen entity in routine practice. One of its most common subtypes is nonspecific granulomatous prostatitis (NSGP), the etiology of which is still under debate. Such cases may be mistaken for adenocarcinoma clinically and radiologically. Histological resemblance to adenocarcinoma may arise when there is a xanthogranulomatous pattern or a prominence of epithelioid histiocytes. However, NSGP may rarely coexist with adenocarcinoma and it is critical to sample these cases thoroughly to exclude the presence of malignancy.