Department of Ultrasound, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College, No. 1 MaoYuan South Road, Shunqing District, Nanchong, 637000, Sichuan, China.
Department of Breast and Thyroid Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China.
BMC Med Imaging. 2022 Sep 2;22(1):155. doi: 10.1186/s12880-022-00885-4.
This study aimed to compare the diagnostic accuracy of high-frequency ultrasound (HFUS) and fiberoptic ductoscopy (FDS) for pathologic nipple discharge (PND).
HFUS and FDS were conducted in 210 patients with PND (248 lesions) treated at our hospital. The diagnostic accuracy of these two methods was compared using pathological diagnosis as the standard.
Among 248 lesions, 16 and 15 of 16 malignant lesions were accurately diagnosed by HFUS and FDS, respectively. Of 232 benign lesions, 183 and 196 cases were accurately diagnosed by HFUS and FDS, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of HFUS in diagnosis of intraductal lesions were 84.36% (95% CI 79.26-88.39%), 60% (95% CI 23.07-92.89%), 96.03% (95% CI 96.55-99.83%), and 7.31% (95% CI 2.52-19.4%) respectively. The sensitivity, specificity, PPV, and NPV of FDS in diagnosis of intraductal lesions were 86.83% (95% CI 82.00-90.52%), 100% (95% CI 56.55-100%), 100% (95% CI 98.21-100%), and 13.51% (95% CI 5.91-27.98%) respectively. Diagnostic accuracy rates of HFUS and FDS were 83.87% (208/248) and 85.08% (211/248), respectively, exhibiting no statistically differences (χ = 0.80, P > 0.05). The accuracy of HFUS combined with FDS was 93.14% (231/248), showing statistically differences (χ = 10.91, P < 0.05).
Both HFUS and FDS demonstrated high diagnostic values for PND. HFUS has the advantage of non-invasive for nipple discharge with duct ectasia, exhibited good qualitative and localization diagnostic values. It is the preferred evaluation method for patients with nipple discharge. When HFUS cannot identify the cause of PND, FDS can be considered.
本研究旨在比较高频超声（HFUS）和纤维乳管镜（FDS）对病理性乳头溢液（PND）的诊断准确性。
对我院收治的 210 例 PND（248 处病变）患者进行 HFUS 和 FDS 检查。以病理诊断为标准，比较两种方法的诊断准确性。
248 处病变中，HFUS 和 FDS 分别准确诊断出 16 处恶性病变中的 16 处和 15 处。232 处良性病变中，HFUS 和 FDS 分别准确诊断出 183 处和 196 处。HFUS 对导管内病变的诊断灵敏度、特异度、阳性预测值（PPV）和阴性预测值（NPV）分别为 84.36%（95%CI 79.26%-88.39%）、60%（95%CI 23.07%-92.89%）、96.03%（95%CI 96.55%-99.83%）和 7.31%（95%CI 2.52%-19.4%）。FDS 对导管内病变的诊断灵敏度、特异度、PPV 和 NPV 分别为 86.83%（95%CI 82.00%-90.52%）、100%（95%CI 56.55%-100%）、100%（95%CI 98.21%-100%）和 13.51%（95%CI 5.91%-27.98%）。HFUS 和 FDS 的诊断准确率分别为 83.87%（208/248）和 85.08%（211/248），差异无统计学意义（χ=0.80，P>0.05）。HFUS 联合 FDS 的准确率为 93.14%（231/248），差异有统计学意义（χ=10.91，P<0.05）。
HFUS 和 FDS 对 PND 均具有较高的诊断价值。HFUS 对乳管扩张伴乳头溢液具有非侵入性的优势，具有良好的定性和定位诊断价值。是乳头溢液患者的首选评估方法。当 HFUS 不能明确 PND 病因时，可考虑 FDS。
