Objective Granulomatous prostatitis mimics prostate cancer clinically. This study evaluated conventional transrectal ultrasound (TRUS) and contrast enhanced ultrasound (CELTS) findings of granulomatous prostatitis. Methods Thirty-seven cases of granulomatous prostatitis were culled from 2 215 consecutive men who underwent needle biopsy. Patients underwent TRUS. CEUS and histopathologic examination. Results Sonographically, 25 cases appeared solitary or multiple hypoechoic nodules in glands. Heterogeneous hypoechoic lesions with poor-defined margin in the peripheral zone were observed in 8 patients. One case presented multiple cysts and solid nodules in the gland and hypoechoic lesion involved seminal vesicles. In the remaining three patients, the gland showed a homogeneous normal echotexture. Three patients underwent CEUS. After administration of SonoVue, the lesion of one case displayed wash in simultaneously and rapidly wash out. The other two cases displayed no-enhancement areas and the boundaries were conspicuous. Conclusions It's difficult to make a specific diagnosis of granulmoatous prostatitis with nodules or differentiate it from prostate cancer only by conventional TRUS, and biopsy is still necessary. The sign of CEUS, which is no-enhancement areas, might be possible to distinguish granulmoatous prostatitis from prostate caner and very helpful in guided biopsy.%目的 肉芽肿性前列腺炎与前列腺癌难以鉴别,本研究分析肉芽肿性前列腺炎的经直肠常规超声(TRUS)和超声造影(CEUS)图像特征,以提高该病的超声诊断水平.方法 在我科行TRUS引导下前列腺穿刺活检的2 215例中经病理确诊为肉芽肿性前列腺炎者37例,分析其TRUS及CEUS特征、临床症状及病理资料.结果 TRUS示25例前列腺有单发或多发低回声结节；8例表现为周围区边界不清的低回声区；1例可见腺体内多发性囊、实性结节,病变累及精囊腺；3例常规超声检查无阳性发现.CEUS者3例.1例病灶为等增强、廓清略早于周围实质；2例病灶无增强,边界清楚.结论 肉芽肿性前列腺炎病灶表现为结节样者超声较难将其与前列腺癌进行区分,CEUS能观察到不增强的坏死区,有助于引导穿刺和明确诊断.
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