Jiang Bo, Gao Yinguang, Yu Haiyue, Hu Xiangdong, Tan Xiaoqu, Qiu Lanyan, Zhang Hong, Liu Jinping, Ma Xia, Qu Xiang
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Breast Surgery Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Ultrasound Med Biol. 2024 Feb;50(2):191-197. doi: 10.1016/j.ultrasmedbio.2023.09.017. Epub 2023 Nov 7.
The aim of the work described here was to investigate the feasibility and diagnostic value of using contrast-enhanced ultrasound (CEUS) galactography with SonoVue in patients with pathologic nipple discharge (PND).
Twenty-eight patients who underwent breast surgery for PND from May 2019 to August 2021 were included. Routine ultrasound, ductoscopy and CEUS galactography were performed successively. Lesions were diagnosed and localized. The sensitivity, specificity and pre-operative localization value of each examination method were evaluated on post-operative pathology.
CEUS galactography was successfully conducted in all 28 patients and revealed negative ductal ectasia, filling stop and filling defect. Ductoscopy revealed positive nodules in 21 cases and negative nodules in 7 cases. A total of 18 nodules were found by routine ultrasound, and the relationship between all nodules and the discharge duct was confirmed after CEUS galactography. Compared with the other two methods, CEUS galactography had higher sensitivity, positive predictive value and negative predictive value (100%, 81.82% and 100%, respectively), while it has the same specificity as routine ultrasound (both 60%). The pre-operative location of the nipple duct was consistent with the intra-operative findings in 28 patients after CEUS galactography.
The ultrasound contrast agent SonoVue can be used for CEUS galactography in patients with PND. CEUS galactography can improve the detection of ductal nodules and locate the nipple discharge duct pre-operatively. As the technique does not emit radiation and SonoVue is easily metabolized and safe, CEUS galactography is better than conventional imaging for PND patients.
本文所述工作的目的是研究使用超声造影剂（CEUS）联合声诺维进行乳管造影在病理性乳头溢液（PND）患者中的可行性及诊断价值。
纳入2019年5月至2021年8月因PND接受乳腺手术的28例患者。依次进行常规超声、乳管镜检查及CEUS乳管造影。对病变进行诊断和定位。根据术后病理评估每种检查方法的敏感性、特异性及术前定位价值。
28例患者均成功进行了CEUS乳管造影，显示导管扩张阴性、充盈中断及充盈缺损。乳管镜检查发现21例结节阳性，7例结节阴性。常规超声共发现18个结节，CEUS乳管造影后确定了所有结节与溢液导管的关系。与其他两种方法相比，CEUS乳管造影具有更高的敏感性、阳性预测值和阴性预测值（分别为100%、81.82%和100%），而其特异性与常规超声相同（均为60%）。28例患者经CEUS乳管造影后乳头导管的术前定位与术中发现一致。
超声造影剂声诺维可用于PND患者的CEUS乳管造影。CEUS乳管造影可提高导管结节的检出率并在术前定位乳头溢液导管。由于该技术不发射辐射且声诺维易于代谢且安全，CEUS乳管造影对PND患者优于传统成像。
