Answer for BIR CoW 16 Apr 2023
PROSTATIC ABSCESS
Findings
Multiple well defined T1 isointense,T2 heterointense lesions with peripheral hypointense rim,seen diffusely in both transitional and peripheral zone of prostate,showing peripheral rim of diffusion restriction ,largest measuring 2.1x 1.5 cm in left transitional zone Impression Multiple well defined T2 heterointense lesions with peripheral rim of diffusion restriction in both transitional and peripheral zones of prostate – Features suggestive of prostatic abscesses
Discussion
Prostatic abscesses are a rare complication of prostatitis It tends to affect diabetic and immunocompromised patients Most affected patients are around 50-60 years old The organisms usually involved include:Escherichiacoli,staphylococcus spp. and gonococcus spp. Patients usually presents with dysuria,fever,suprapubic pain and possibly urinary retention The sonographic pattern of prostatic abscesses is usually characteristic and can thus be easily differentiated from other glandular lesions Abscesses generally appear as wide hypoechoic zones;sometimes a hypoechoic perilesional halo can be identified around an abscesses,which is absent in tumours CT was found to be useful to assess the extent of supparative material that had collected in the periprostatic tissue and to detect gas in the fluid MRI shows hypointense signal on T1W images and a hyperintense signal on T2W images with peripheral contrast enhancement DWI tends to show restricted diffusion corresponding to hypoechoic lesions on ultarsound High resolution MRI using an endorectal or pelvic array coil is widely used in patients with prostate carcinoma
References:
1.Prostatic abscesses MRI findings :Case reporting,Osama A.Samara, Walid M.Farah (J Med J 2013;Vol 47(3) : 266 -272)
2.Diffusion weighted MRI in prostatic abscess :Singh P,Yadav MK, Singh SK et-al .Indian J Radiol Imaging 2011;21(1) :46-8
Findings
Multiple well defined T1 isointense,T2 heterointense lesions with peripheral hypointense rim,seen diffusely in both transitional and peripheral zone of prostate,showing peripheral rim of diffusion restriction ,largest measuring 2.1x 1.5 cm in left transitional zone Impression Multiple well defined T2 heterointense lesions with peripheral rim of diffusion restriction in both transitional and peripheral zones of prostate – Features suggestive of prostatic abscesses
Discussion
Prostatic abscesses are a rare complication of prostatitis It tends to affect diabetic and immunocompromised patients Most affected patients are around 50-60 years old The organisms usually involved include:Escherichiacoli,staphylococcus spp. and gonococcus spp. Patients usually presents with dysuria,fever,suprapubic pain and possibly urinary retention The sonographic pattern of prostatic abscesses is usually characteristic and can thus be easily differentiated from other glandular lesions Abscesses generally appear as wide hypoechoic zones;sometimes a hypoechoic perilesional halo can be identified around an abscesses,which is absent in tumours CT was found to be useful to assess the extent of supparative material that had collected in the periprostatic tissue and to detect gas in the fluid MRI shows hypointense signal on T1W images and a hyperintense signal on T2W images with peripheral contrast enhancement DWI tends to show restricted diffusion corresponding to hypoechoic lesions on ultarsound High resolution MRI using an endorectal or pelvic array coil is widely used in patients with prostate carcinoma
References:
1.Prostatic abscesses MRI findings :Case reporting,Osama A.Samara, Walid M.Farah (J Med J 2013;Vol 47(3) : 266 -272)
2.Diffusion weighted MRI in prostatic abscess :Singh P,Yadav MK, Singh SK et-al .Indian J Radiol Imaging 2011;21(1) :46-8
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!