Ultrasonographic Evaluation of Prostatic Pathology and its Correlation with MRI wherever Required

Abstract

Background: The prostate glands the largest accessory gland of the male reproductive system. In adults, it typically weighs ~40 grams and has an average size of 3 x 4 x 2 cm ^[1]. On imaging, the upper limit of normal is considered to be 30 mL.^[2] The prostate comprises 70% glandular tissue and 30% fibromuscular or stromal tissue^[3] and provides ~30% of the volume of seminal fluid. Ultrasound best assessed with transrectal ultrasound. Outer gland (central and peripheral zones) - uniform low echogenicity but usually more echogenic than the inner gland. ^{[4, 5]} The prostate is covered in a surface called the prostatic capsule or prostatic fascia. The most common types of prostate disease are benign prostatic hyperplasia (BPH), prostatitis and prostate cancer (PCa).

Objective: To evaluate the prostatic pathology by transabdominal ultrasound, Transrectal ultrasound (whenever required) and corelate the all these findings with MRI.

Methods: Patients with lower urinary tract symptoms, were selected for study. A thorough case history was taken followed by Ultrasonography / MRI examination of pelvis. The study was conducted in the department of Radiodiagnosis at N.S.C.B. Medical College Jabalpur.

Result: Among 100 patients most patients were more than 60yrs of age. It was found that maximum cases 56% showed prostatic hypertrophy, 36% had prostatic calcification, 1% had prostatic carcinoma, 5%had prostatitis and 2% had prostatic abscess. On MRI 9% cases showed PI-RADS category 1, 4% were normal, 3% showed blooming artifact, 2% were hyperintense on T2 and 5% had Ca Prostate.

Conclusion: Our research study advocates that ultrasound is a simple, widespread available and a sensitive modality that can be advocated as the imaging investigation for diagnosing various prostatic pathologies. And MRI is recommended for a more precise diagnosis of prostate pathology.