Scheurlen K, Schnitzer A, Krammer J, Kaiser C, Schönberg S O, Wasser K
Institut für Klinische Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
Radiologe. 2014 Feb;54(2):160-6. doi: 10.1007/s00117-013-2573-7.
The survey results of a previous study showed that galactography is now rarely used in Germany and newer methods are applied. The evidential value of galactography should be established and opposed to the evidential value of ultrasound (US) and magnetic resonance mammography (MRM).
A search was carried out in PubMed and Cochrane involving studies written in English or German. The level of evidence was measured according to the Oxford Centre for Evidence-based Medicine.
A total of 19 studies were included, 14 with results on galactography, 10 on US and 5 on MRM. Almost all studies were retrospective with an evidence assigned to level 3b or lower. The results on the diagnostic values showed a very wide range. Because of very variable numbers of cases and consideration of various pathologies, the studies are only comparable to a limited extent.
Galactography, US and MRM all show a weak level of evidence and no superiority of a particular method can be derived. Therefore, galactography can no longer be considered as a mandatory standard in modern multimodal imaging of the breast. Recommendations for the diagnostic work-up of pathological nipple discharge have to be included in current guidelines and must consider these facts.
一项先前研究的调查结果显示，乳腺导管造影术目前在德国很少使用，取而代之的是更新的方法。应确定乳腺导管造影术的证据价值，并与超声（US）和磁共振乳腺成像（MRM）的证据价值进行对比。
在PubMed和Cochrane中进行检索，纳入用英文或德文撰写的研究。证据水平根据牛津循证医学中心的标准进行衡量。
共纳入19项研究，其中14项涉及乳腺导管造影术的结果，10项关于超声，5项关于磁共振乳腺成像。几乎所有研究都是回顾性的，证据等级被评定为3b级或更低。诊断价值的结果显示出很大差异。由于病例数量差异很大且考虑了各种病理情况，这些研究仅在有限程度上具有可比性。
乳腺导管造影术、超声和磁共振乳腺成像均显示出较弱的证据水平，无法得出某一特定方法具有优越性的结论。因此，在现代乳腺多模态成像中，乳腺导管造影术不能再被视为强制性标准。关于病理性乳头溢液诊断检查的建议必须纳入当前指南，并必须考虑这些事实。
