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Dopplerography of the prostate and seminal vesicles
Last reviewed: 23.04.2024
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With the advent of techniques such as color and energy Doppler mapping, tissue harmonics, three-dimensional echography and three-dimensional angiography, echocontrast angiography, the diagnosis of prostate diseases has moved to a new level. With the help of new ultrasound imaging technologies of prostate tissue and its vascular structures, it became possible to perform high-precision diagnostics of the earliest forms of diseases and monitor treatment.
The blood supply of the prostate comes from the paired prostatic arteries, which are branches of the lower-bubble artery. They follow anteriorly from the anterior fibrous-muscular zone and form a dense plexus on the surface of the gland. The central part of the gland secreters the urethral arteries, to the peripheral part - the capsular. In the blood supply of the gland are also involved paired lower genitalia, passing in the paraprostatic fiber back and lateral from the prostate gland in the neuromuscular bundle. They give separate twigs participating in the blood supply to the posterior sections of the gland. The veins form plexuses in the surrounding paraprostatic fiber on the lateral surfaces of the gland.
In transrectal longitudinal scanning, the prostatic artery is defined above the anterior fibrous-muscular zone and follows along it in paraprostatic fiber. It is often difficult to visualize it throughout the course, due to a twisted course. From the prostatic artery to the central part of the gland go urethral arteries, and to the peripheral part of the gland - capsular arteries.
The energy mapping mode is widely used at present and is considered the most informative for visualization of the vessels of the prostate gland. It allows to visualize smaller vessels of the gland and to locate capsular vessels of the peripheral zone, the course of which is perpendicular to the ultrasound ray. With three-dimensional volumetric reconstruction in the energy mapping mode, it is possible to imagine the course and the location of the vessels in the parenchyma of the gland. The distribution of the vessels in the prostate gland is uniform, fan-shaped. When comparing the vascular pattern of the right and left lobes of the prostate gland on the transverse sections is symmetrical and evenly distributed, which was demonstrated in a series of experimental studies.
The results of a study of hemodynamics in the vessels of the prostate showed that the prostatic artery has a high, narrow, acute systolic peak and a low-amplitude flat diastolic. The values of the peak blood flow velocities in the prostatic artery averaged 20.4 cm / s (16.6 to 24.5 cm / s), IR 0.92 (0.85 to 1.00).
Dopplerograms of the urethral and capsular arteries are comparable, they have a medium wide amplitude, an acute systolic peak and a flat diastolic one. The values of peak blood flow velocities and MI in urethral and capsular arteries are similar and on the average equal to 8.19 ± 1.2 cm / s and 0.58 ± 0.09, respectively. Dopplerograms of the veins of the prostate gland do not have oscillator phases, representing a mid-amplitude straight line. The average velocity in the veins of the prostate gland varies from 4 to 27 cm / s, averaging 7.9 cm / s.
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