Zhao Yanchun, Wu Songsong, Bao Zhongtao, Lin Yucheng, Xu Ziwei, Chen Xing, Tang Lingpeng, Lyu Guorong
Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Licheng District, Quanzhou, Fujian, 362000, China.
Department of Ultrasonography, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China.
BMC Med Imaging. 2025 Apr 23;25(1):132. doi: 10.1186/s12880-025-01674-5.
The goal of this research study is to determine the efficacy of dual contrast-enhanced ultrasound (US) in evaluating ductal papillary lesions associated with pathological nipple discharge.
A prospective multicenter study was conducted between January 2020 and December 2022. All participants were examined using dual contrast-enhanced US and had re-adjustment of BI-RADS classification. Genuine ductal papillary lesions were identified using US features and subsequently subjected to biopsy or excision. Using pathological results and clinical follow-up as the reference standard as a standard reference, we compared the diagnostic efficacy of dual contrast-enhanced US to conventional US in detecting papillary lesions.
The study included 102 female participants ranging in age from 29 to 80 years (average 47.6 ± 9.4), of whom 87 were retained for analysis. We precisely localized discharging ducts with papillary lesions in 85 patients, with 68 showing varying degrees of enhancement in papillary lesions. Compared to conventional US, dual contrast-enhanced US was more accurate in locating and detecting papillary lesions (P < 0.001). The optimized BI-RADS classification allowed for a more informed prediction of the malignancy risk associated with papillary lesions. Multivariate logistic regression analysis revealed that ductal continuity, the boundary between the nodule and duct, and peak intensity are independent risk factors for malignancy. The area under the curve for detecting malignant papillary lesions was 0.937.
Dual contrast-enhanced US is effective at precisely locating lactiferous ducts in pathological nipple discharge, detecting and differentiating papillary lesions, and improving the accuracy of BI-RADS classification.
本研究的目的是确定双对比增强超声（US）在评估与病理性乳头溢液相关的导管乳头状病变中的疗效。
于2020年1月至2022年12月进行了一项前瞻性多中心研究。所有参与者均接受双对比增强超声检查，并重新调整了BI-RADS分类。利用超声特征识别真正的导管乳头状病变，随后进行活检或切除。以病理结果和临床随访作为标准参考，比较双对比增强超声与传统超声在检测乳头状病变方面的诊断效能。
该研究纳入了102名年龄在29至80岁之间（平均47.6±9.4岁）的女性参与者，其中87名被保留用于分析。我们在85例患者中精确定位了伴有乳头状病变的溢液导管，其中68例乳头状病变表现出不同程度的增强。与传统超声相比，双对比增强超声在定位和检测乳头状病变方面更准确（P<0.001）。优化后的BI-RADS分类有助于更明智地预测与乳头状病变相关的恶性风险。多因素逻辑回归分析显示，导管连续性、结节与导管之间的边界以及峰值强度是恶性肿瘤的独立危险因素。检测恶性乳头状病变的曲线下面积为0.937。
双对比增强超声在精确定位病理性乳头溢液中的输乳管、检测和鉴别乳头状病变以及提高BI-RADS分类准确性方面有效。
