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Lebovici A, Csutak C, Popa P, Crișan N, Suciu M, Feciche B, Andraș I, Ștefan PA, Feier DS. Magnetic resonance imaging characteristics of chronic prostatitis in patients under the age of 50: is it more than the eye can see? Acta Radiol 2022; 63:839-846. [PMID: 33940959 DOI: 10.1177/02841851211010397] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The magnetic resonance (MRI) diagnosis of chronic prostatitis (CP) is insufficiently evaluated. PURPOSE To evaluate the MRI appearance of CP in young patients by comparing it to individuals with non-prostatic related pathology. MATERIAL AND METHODS The study included 47 patients with prostatitis-like symptoms evaluated by urologists and referred to pelvic MRI examination (mean age=40.23±7 years; age range=23-49 years) and 93 age-matched individuals with non-prostatic related pathology (mean age=37.5±7 years; age range=21-49 years). All MRI examinations were performed on a 1.5-T machine using a prostate-specific protocol for the prostatitis group and different protocols that included high-resolution small field of view T2-weighted (T2WI) and diffusion-weighted imaging (DWI), for the control group, depending on the clinical indication. RESULTS Four different T2WI intensity patterns were observed: hyperintense homogenous; slightly to moderate homogenous hypointense; inhomogeneous; and marked hypointense. We found statistically significant differences between the two analyzed groups regarding mean ADC values (P<0.001), distribution of T2WI intensity patterns (P<0.0001), and the presence of dilated venous plexus (P=0.0007). No differences were found regarding prostate volume (P=0.15). In multivariate analysis, all four analyzed imaging parameters were independent predictors of chronic prostatitis (R2=0.67; P<0.0001). Considered together, an age >28 years, an inhomogeneous or marked hypointense T2WI intensity pattern (types 3 and 4), an ADC value ≤1250, and the presence of dilated venous plexus are able to predict CP with an AUC of 93% (sensitivity=85.1%, specificity=88.4%). CONCLUSION MR parameters like T2WI intensity patterns, ADC values, and venous plexus appearance are promising non-invasive tools in the challenging environment of CP diagnosis.
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Affiliation(s)
- Andrei Lebovici
- Radiology, Surgical Specialties Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Affidea Imaging Center, Cluj-Napoca, Romania
- Radiology and Imaging Department, County Emergency Hospital, Cluj-Napoca, Romania
| | - Csaba Csutak
- Radiology, Surgical Specialties Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Radiology and Imaging Department, County Emergency Hospital, Cluj-Napoca, Romania
| | - Paula Popa
- Radiology, Surgical Specialties Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Nicolae Crișan
- Department of Urology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Urology, Clinical Municipal Hospital Cluj-Napoca, Cluj-Napoca, Romania
| | - Mihai Suciu
- Department of Urology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Institute of Urology and Renal Transplant, Cluj-Napoca, Romania
| | - Bogdan Feciche
- Department of Urology, Satu-Mare County Emergency Hospital, Satu-Mare, Romania
| | - Iulia Andraș
- Department of Urology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Urology, Clinical Municipal Hospital Cluj-Napoca, Cluj-Napoca, Romania
| | - Paul-Andrei Ștefan
- Radiology, Surgical Specialties Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Anatomy and Embryology, Morphological Sciences Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Sorina Feier
- Radiology, Surgical Specialties Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Affidea Imaging Center, Cluj-Napoca, Romania
- Radiology and Imaging Department, County Emergency Hospital, Cluj-Napoca, Romania
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Pathak RA, Geiger X, Ericson C, Wilson RRA, Petrou SP. Histologic Analysis of Urethral Stricture in 9 Patients Following Dorsal Vaginal Graft Urethroplasty. Am J Clin Pathol 2022; 157:742-747. [PMID: 34724532 DOI: 10.1093/ajcp/aqab183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/19/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To present the pathologic analysis of female urethral strictures obtained during reconstructive urethroplasty. METHODS Nine separate female urethral tissue specimens were obtained during dorsal vaginal graft urethroplasty by a single surgeon (S.P.P.). Samples were serially sectioned and fixed in 10% formalin 6 to 12 hours before routine processing in paraffin blocks. Serial 5-µm sections were subjected to H&E, Masson trichrome, and elastin staining. End point analysis included evaluation for epithelial hyperplasia and cell type, mucosal edema, degree of fibroblast/inflammatory cell infiltrate, and elastin fiber density and distribution. RESULTS Nine specimens were examined. Six specimens had epithelial linings of stratified squamous epithelium overlying fibrosis (67%), 1 had mixed squamous and urothelial epithelium, and 2 had only urothelial epithelium. Two specimens (29%) showed acute injury with prominent squamous papillary hyperplasia, focal erosion, and patchy mucosal hemorrhage. Areas of urethral stricture were variably thickened, with increased, densely packed collagen fibers and associated mucosal lymphocytic inflammation ranging from mild and patchy to focally dense with lymphoid aggregates. The highest elastin fiber density appeared to be associated with vessels and overlying muscle bundles in the submucosa. CONCLUSIONS Further elucidation of histopathologic characteristics may illuminate more appropriate therapeutic pathways for female urethral stricture disease management.
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Affiliation(s)
- Ram A Pathak
- Department of Urology, Wake Forest University, Winston-Salem, NC, USA
| | | | | | | | - Steven P Petrou
- Department of Urology, Wake Forest University, Winston-Salem, NC, USA
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Imaging of chronic male pelvic pain: what the abdominal imager should know. Abdom Radiol (NY) 2020; 45:1961-1972. [PMID: 31834458 DOI: 10.1007/s00261-019-02353-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Chronic pelvic pain is an important but underrecognized cause of morbidity in men. While there is abundant literature discussing female pelvic pain and the diagnostic role of imaging, much less attention has been given to imaging of non-gynecologic causes of chronic pelvic pain. Chronic pelvic pain in men can be a challenge to diagnose as pain may arise from visceral, musculoskeletal, or neurovascular pathology. Imaging of the pelvic viscera has been covered in detail elsewhere in this edition and therefore will not be reviewed here. We will focus upon topics less familiar to the abdominal radiologist, including imaging of pelvic floor, musculoskeletal, and neurovascular pathology.
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Clemente A, Renzulli M, Reginelli A, Bellastella G, Brusciano L, Biselli M, Schiavina R, Golfieri R, Cappabianca S. Chronic prostatitis/pelvic pain syndrome: MRI findings and clinical correlations. Andrologia 2019; 51:e13361. [DOI: 10.1111/and.13361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 05/21/2019] [Accepted: 06/07/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Alfredo Clemente
- Radiology and Radiotherapy Unit, Department of Precision Medicine University of Campania "L. Vanvitelli" Naples Italy
| | - Matteo Renzulli
- Radiology Unit, Department of Diagnostic Medicine and Prevention Sant'Orsola Hospital, University of Bologna Bologna Italy
| | - Alfonso Reginelli
- Radiology and Radiotherapy Unit, Department of Precision Medicine University of Campania "L. Vanvitelli" Naples Italy
| | - Giuseppe Bellastella
- Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences University of Campania "L. Vanvitelli" Naples Italy
| | - Luigi Brusciano
- Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences University of Campania "L. Vanvitelli" Naples Italy
| | - Maurizio Biselli
- Department of Medical and Surgical Sciences Sant'Orsola Hospital, University of Bologna Bologna Italy
| | - Riccardo Schiavina
- Department of Urology Sant'Orsola Hospital, University of Bologna Bologna Italy
| | - Rita Golfieri
- Radiology Unit, Department of Diagnostic Medicine and Prevention Sant'Orsola Hospital, University of Bologna Bologna Italy
| | - Salvatore Cappabianca
- Radiology and Radiotherapy Unit, Department of Precision Medicine University of Campania "L. Vanvitelli" Naples Italy
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