Cross sectional imaging features of prostatitis
Prostatitis is inflammation or infection of the prostate gland. It is one of the most common urologic diseases in the United States and may be acute or chronic in clinical presentation. In men <35 years old, acute bacterial prostatitis (most often by Gram negative organisms) is most common, whereas in older men, nonbacterial prostatitis is most common.
On TRUS, focal, multifocal, or diffuse areas of decreased echogenicity may be seen. On MRI, both T1-weighted and T2-weighted images demonstrate low signal intensity foci in the peripheral zone, usually without associated contour deformity. There may be associated findings in acute prostatitis such as enlargement of the prostate gland, increased enhancement on CT and MRI, increased blood flow on Doppler US, and periprostatic inflammatory changes.
Granulomatous infections such as tuberculosis may lead to seminal vesiculitis, which manifests on imaging as wall thickening, loss of convolutions, or atrophy of the seminal vesicles. Calcifications may be seen in the prostate gland, vasa deferentia, and seminal vesicles in patients with granulomatous infection.