Departments of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
Department of Radiology Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
Med Ultrason. 2020 Mar 1;22(1):58-64. doi: 10.11152/mu-2141.
The objective of this study was to evaluate the diagnostic performance of second-look breast ultrasound (US) immediately after galactography in patients with nipple discharge.
Between January 2010 and November 2018, 89 patients with nipple discharge were retrospectively analyzed. All patients were examined by galactography and US. US was performed twice, before and after galactography. Galactography, mammography and US findings were categorized according to the Breast Imaging Reporting and Data System (BI-RADS). The final diagnosis was established by histopathological examination.
Out of 89 patients, 25 (28.1%) patients had positive findings as evident by US before galactography. Forty-eight (53.9%) patients had positive findings as demonstrated by galactography. Fifty-nine (66.3%) patients had positive findings as evident by second-look US after galactography (13 patients with benign, 37 with borderline and 9 with malignant lesions). Second-look US after galactography showed the highest diagnostic accuracy (83.2%), sensitivity (95.8%) and negative predictive value (93.3%) for borderline and malignant lesions. For the detection of malignant lesions, secondlook US after galactography showed the highest sensitivity (90%) and negative predictive value (96.7%). Agreement between imaging and histological result using Bland-Altman analysis exhibited no significant difference between the size establishedby ultrasound and galactography.
The second-look US after galactography is a powerful diagnostic tool for the detection of lesions in patients with nipple discharge and demonstrates high diagnostic accuracy, sensitivity and negative predictive value.
本研究旨在评估乳管造影后即刻行乳腺超声（US）检查对乳头溢液患者的诊断性能。
回顾性分析 2010 年 1 月至 2018 年 11 月间 89 例乳头溢液患者。所有患者均行乳管造影及 US 检查，US 检查分别于造影前及造影后进行。根据乳腺影像报告和数据系统（BI-RADS）对乳管造影、乳腺 X 线摄影及 US 检查结果进行分类。最终诊断依据组织病理学检查结果确定。
89 例患者中，造影前 US 检查有 25 例（28.1%）阳性表现，乳管造影阳性者 48 例（53.9%），乳管造影后行第 2 次 US 检查阳性者 59 例（66.3%），其中良性病变 13 例，交界性病变 37 例，恶性病变 9 例。乳管造影后行第 2 次 US 检查对交界性和恶性病变的诊断准确性（83.2%）、敏感度（95.8%）及阴性预测值（93.3%）最高。在检测恶性病变方面，乳管造影后行第 2 次 US 检查的敏感度（90%）及阴性预测值（96.7%）最高。 Bland-Altman 分析显示，超声和乳管造影建立的病变大小之间无显著差异。
乳管造影后行第 2 次 US 检查是一种强有力的诊断工具，可用于检测乳头溢液患者的病变，具有较高的诊断准确性、敏感度和阴性预测值。
