Ultrasonographic findings in prostatitis.
Ultrasonographic findings in prostatitis.
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前列腺炎的超声检查结果。
DOI：
10.1001/archinte.1988.00380030209032
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发表时间：
1989
期刊：
影响因子：
--
通讯作者：
S. Carter
中科院分区：
文献类型：
--
作者：
A. Doble;S. Carter
经直肠前列腺超声检查是一种微创、无痛的检查，可提供前列腺的客观数据。前列腺炎是一种很难诊断的疾病，因为它的病理学变化和缺乏体征。目前的诊断依据是在Stamey定位程序中获得的前列腺分泌物中发现过多的白细胞。与前列腺炎诊断有显著相关性的7个超声特征已被确定：高密度和中等范围回声，回声透亮区，包膜不规则和增厚，射精管回声，和会阴区不规则。超声检查证实了炎症性前列腺疾病的局灶性和常见的外周区定位。短时间内的随访超声研究显示，回声透明区可消退为正常、中等或高密度回声，同时前列腺液中白细胞计数下降。在超声控制下准确放置活检针的能力使得能够对实质特征进行组织学评估。高密度回声代表淀粉体;中等密度回声代表炎症、纤维化或两者兼有;回声透明区代表炎症。中等和高密度回声的低特异性（51.9%和40.7%）和低敏感性（范围30.8%至62.3%）的其余五个超声特征的前列腺炎排除识别任何一个特征作为诊断这种情况。一个可能的例外可能是回声透明区的发现，这也可能被证明是有用的治疗反应的监测。在个体前列腺内检测到几种体征提示慢性前列腺炎的诊断，而在具有前列腺炎症状的患者中进行正常扫描高度提示前列腺痛。
Transrectal prostatic ultrasound is a minimally invasive, painless investigation that provides objective data on the topography of the prostate. Prostatitis is a condition difficult to diagnose in view of its varied symptomatology and lack of physical signs. The diagnosis currently rests on the finding of excessive numbers of leukocytes in the prostatic secretion obtained during the Stamey localization procedure. Seven ultrasound features having a significant correlation with a diagnosis of prostatitis have been identified: high-density and mid-range echoes, echo-lucent zones, capsular irregularity and thickening, ejaculatory duct echoes, and periurethral-zone irregularity. Ultrasonography confirms the focal nature and frequent peripheral-zone location of inflammatory prostate disease. Follow-up ultrasound studies over a short period showed that the echo-lucent zones may resolve to normal, mid-range, or high-density echoes in conjunction with a fall in the leukocyte count in expressed prostatic secretions. The ability to place a biopsy needle accurately under ultrasound control has enabled histologic assessment of the parenchymal features. The high-density echoes represent corpora amylacea; the mid-range echoes, inflammation, fibrosis, or both; and the echo-lucent zones, inflammation. The low specificity of mid-range and high-density echoes (51.9 and 40.7 per cent) and the low sensitivity (range 30.8 to 62.3 per cent) of the remaining five ultrasound features of prostatitis preclude identification of any one feature as being diagnostic of this condition. A possible exception may be the finding of echo-lucent zones, which may also prove useful in the monitoring of response to treatment. The detection of several signs within an individual's prostate suggests a diagnosis of chronic prostatitis, whereas a normal scan in a patient with symptoms of prostatitis is highly suggestive of prostatodynia.