CT (computed tomography) prostate
Before the advent of spiral CT examination of the prostate gland using this method was not used, as it gave too little information. Scanning of the body on the multislice computed tomography with dynamic contrast in terms of information not inferior to MRI and can compete with TRUS – basic instrumental methods of diagnosis acute and chronic inflammation, adenoma and prostate cancer. The main advantages of x-ray computed tomography consider the speed of the study and its relatively low cost.
What you can see on the computer imaging of the prostate?
On the computer tomogram of the prostate gland you can see its size and relationship with surrounding structures: the bladder, rectum, seminal vesicles. At the same time to differentiate the internal structure of the organ is not possible, since the outer capsule of the glandular lobules and fibrous and muscular elements have approximately the same radiographic density. Thus, with the help of CT can determine the extent of spread of prostate cancer, but vnutrikapilliarnuu to distinguish tumor growth from BPH or chronic prostatitis is almost impossible.
CT and MRI of the prostate is comparable in content. CT takes less time and is cheaper, MRI is completely harmless, so it would be preferable if planning to conduct research many times.
Contrast increases the information content of the study, in this case it is possible to visualize tumor breast tissue more clearly and to distinguish cancer from diffuse changes in it in chronic prostatitis. Additional oral contrast allows the bowel to more accurately determine the spatial relationship between organs. The most informative method of x-ray diagnosis is considered to be dynamic CT with contrast, this study is conducted on scanners with resolution of at least 64 slices per cycle. The technique is not inferior to MRI in informative, but takes much less time and is cheaper.
In what cases appoint and how to conduct research?
CT scan of the prostate is used in Oncology as a complementary examination in patients with already identified with prostate cancer when it is impossible for more informative MRI:
- to assess germination of the tumor adjacent tissues in patients with a high risk of spread of the cancer scale Gleason;
- to identify regional eliminations in the lymph nodes of the pelvic region;
- when planning surgical treatment and radiotherapy.
CT is indicated for the diagnosis of cancer confirmed cancer, for screening and initial diagnosis, this method is not suitable.
Emergency urology CT scan of the prostate was performed with the purpose of differential diagnosis of acute parenchymatous prostatitis abscess of prostate gland.
Before the examination the patient visits the doctor assesses the General condition, asks to report the presence of established allergies and related chronic diseases, and also specifies the volume of the preparation. He was then placed on the scanner couch, establish an intravenous catheter for administration of contrast medium, which is connected to the automatic injector. The scanning may be performed several times: before the introduction of contrast and multiple phases of absorption.
Contraindications and restrictions of the
Absolute contraindications for computed tomography of the prostate no. For patients receiving radiation therapy, preparation for it should include the individual account the total radiation dose. Because the study without contrast enhancement is uninformative, contraindications for CT scan of the prostate should be considered a disease, in which its introduction danger:
- violation of kidney function;
- diabetes mellitus, thyrotoxicosis;
- severe allergic reaction to yodsoderzhaschie drugs in history;
- bronchial asthma;
- the General severe condition of the patient, chronic diseases in stage of decompensation.
Alternative methods of examination in the pathology of the prostate
Structural changes in the prostate gland can be detected using TRUS (transrectal ultrasound), CT scan and MRI. Each of these methods has its advantages and disadvantages, which define the scope of its use.
- Transrectal ultrasonography non – invasive, harmless procedure that is performed with minimal discomfort to the patient. The transducer of the ultrasonic device inserted into the rectum, this allows maximum close to the prostate and to examine the changes in her. The advantages of this method include: speed of implementation, the possibility of determining the internal structure of the gland, harmlessness, low cost and high availability. Disadvantages – studied only prostate, it is impossible to identify enlarged lymph nodes and to assess the prevalence of tumorous process, the quality of diagnosis is highly dependent on the experience and professionalism conducting the study. This method is more suitable for the diagnosis of chronic prostatitis than to detect cancer.
- MRI and CT are comparable in level of informativeness and equally often used in Oncology. Both methods give complete information about the mutual position of the pelvic organs, change the size and shape of the gland, the presence of tumor nodes and calcification, the germination of cancer in nearby organs. In both cases, the results of the study are reproducible and not fatally depend on the skill of the doctor-diagnostician. The disadvantage of MRI is considered a high cost and duration of the study takes 30-40 minutes and a few hours for processing. CT is cheaper, scanning takes a few minutes, and the result is handed in within the hour. However, the use of CT yodsoderzhaschie contrast often causes complications than formulations based on gadolinium, used in MRI, and the study involves ionizing radiation.
In preparation for the examination
CT scan of the prostate gland without the use of contrast in cases of emergency may be undertaken without training. In the presence of chronic inflammation or tumor (adenoma or cancer) study is planned in advance. In this case, it is recommended to avoid foods that promote excessive gas formation in the intestine (all legumes, dairy products, cabbage, apples, Persky, all kinds of cereals, except rice).
An injection of contrast is performed on an empty stomach, so the last meal should be not later than 6 hours before the scan to drink the water. If you plan additional opacification of the rectum, the night before the study you must do a cleansing enema.
Important to know: a CT scan of the prostate is almost always done with contrast, so the training plan for research to better align with the doctor.
For exhaustion and dehydration, which often occurs in severe chronic diseases or cancer of the prostate, shown intravenous drip of saline and plasma-substituting solutions to reduce the negative effects of contrast and speed its conclusion. This procedure is continued for 24 hours after the study.
In most cases, an allergic reaction to iodine is considered to be a contraindication for injection of contrast, in some cases, the investigation possible after preparation. A few days prescribed antihistamines, and in the day of the test administered corticosteroids.