Case series: Diffusion weighted MRI appearance in prostatic abscess

ArticleinThe Indian journal of radiology and imaging 21(1):46-8 · February 2011with29 Reads
DOI: 10.4103/0971-3026.76054 · Source: PubMed
Abstract

DIFFUSION: weighted MRI (DWI) is a novel technique that analyzes the diffusion of water molecules in vivo. DWI has been used extensively in the central nervous system. Its use in body imaging is on the rise. In the prostate, it has been used in the evaluation of prostatic carcinoma. We present DWI findings in two patients of prostatic abscess.

    • "...ngh et al. reported DWI appearance in 2 cases of PA confirmatively diagnosed by urine test/culture [15]. The PA lesions were visualized with hyperintense T2 signal in the prostate, while the lesions were..."
      Furthermore, some patients may not receive intravenous contrast agent due to a history of allergy or renal failure and may thus be examined with DWI as a stand-alone technique. In 2011, Singh et al. reported DWI appearance in 2 cases of PA confirmatively diagnosed by urine test/culture [15]. The PA lesions were visualized with hyperintense T2 signal in the prostate, while the lesions were poorly visualized on T1W images with peripheral enhancement on post gadolinium images .
    [Show abstract] [Hide abstract] ABSTRACT: To investigate the conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) findings of prostatic abscess (PA) and seminal vesicle abscess (SVA), and to evaluate the quanlitative and quantitative diagnostic value of apparent diffusion coefficient (ADC) for these conditions.
    Full-text · Article · May 2015
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    • "...s containing fluid. However, it may be inconclusive in the initial stages of abscess formation [3, 10]. Additionally, it may cause pain to patients and abscess size may be altered based on the angle of ..."
      TRUS is often used initially and can show one or more hypoechoic areas with well-defined and thick walls containing fluid. However, it may be inconclusive in the initial stages of abscess formation [3, 10]. Additionally, it may cause pain to patients and abscess size may be altered based on the angle of TRUS.
    [Show abstract] [Hide abstract] ABSTRACT: Prostatic abscesses are usually related to gram-negative bacilli. However, methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a substantial cause of prostatic abscesses in recent years. Herein, we report the case of a 31-year-old man with a history of orthotopic liver transplantation 10 years ago who presented with acute onset dysuria and abdominal pain and was diagnosed with a MRSA prostatic abscess. To our knowledge, this is the first case describing a prostatic abscess in a liver transplant recipient and the first reporting MRSA as the causative organism of a prostatic abscess in a solid organ transplant recipient.
    Full-text · Article · Oct 2014
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    • "...g is one or more hypoechoic areas with well-defined and thick walls containing thick liquid fluid [17]. TRUS can be interpreted variously in other conditions such as neoplastic processes, cystic lesion..."
      TRUS can be used initially and easily to make a diagnosis of prostatic abscess. The most common TRUS finding is one or more hypoechoic areas with well-defined and thick walls containing thick liquid fluid [17]. TRUS can be interpreted variously in other conditions such as neoplastic processes, cystic lesions, or granulomas.
    [Show abstract] [Hide abstract] ABSTRACT: Prostatic abscess is an uncommon urologic disease but has a high mortality rate if not treated properly. Furthermore, diagnosis and proper treatment of prostatic abscesses remains a challenge for physicians. Therefore, we compared data on conservative treatments, transurethral resection of prostatic abscess, and transrectal ultrasound (TRUS)-guided needle aspiration in 52 cases over a 10-year period. The records of 52 patients diagnosed with prostatic abscess by computed tomography at Gangnam Severance Hospital between January 2000 and September 2010 were retrospectively reviewed. All patients were discharged when their leukocytosis had normalized and they had been free of fever for 2 days. Multivariate regression analysis was done to determine independent risk factors for the length of hospitalization. At the time of diagnosis, the average age of the 52 patients was 61.3 years (range, 33 to 81 years), the average volume of the prostate was 56.3 ml (range, 21 to 223 ml), the average prostate-specific antigen was 18.54 ng/ml (range, 2.0 to 57.0 ng/ml), and the average abscess size was 3.8 cm (range, 2.1 to 5.5 cm). All patients were treated with parenteral antibiotics during their hospital stay with intravenous antibiotics (fluoroquinolone monotherapy or 3rd-generation cephalosporin in combination with an aminoglycoside). Of 52 patients, 22 had diabetes mellitus (42.3%), 19 had hypertension (36.5%), and 7 (13.5%) had paraplegia due to spinal cord injury. The most common symptoms were fever (47, 90.4%), perineal discomfort (43, 82.7%), dysuria (40, 76.9%), and urinary retention (29, 55.8%). Prostatic abscesses were treated by conservative treatment (11 cases), transurethral resection of prostatic abscess (23 cases), and TRUS-guided needle aspiration (18 cases). The average hospitalization stay was 17.5 days (range, 6 to 39 days); that of conservative treatment patients was 19.1 days (range, 9 to 39 days). Patients treated by transurethral resection of prostatic abscess and TRUS-guided needle aspiration stayed 10.2 days (range, 6 to 15 days) and 23.25 days (range, 18 to 34 days), respectively. Of the 18 cases who underwent needle aspiration, prostatic abscesses recurred in 4 cases (22.2%) within 1 month after patient discharge. The 2 patients subjected to conservative treatment died due to sepsis. We found no independent factors that affected the average hospitalization period. Patients with prostatic abscess treated by transurethral resection of the prostate had a significantly shorter hospitalization length compared with needle aspiration.
    Full-text · Article · Dec 2012 · Korean journal of urology
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