乳腺导管造影诊断乳腺溢液疾病的研究

分析乳腺溢液疾病在乳腺导管造影术中的影像学表现,明确检查之必要性。本组98例乳腺溢液性疾病患者全部同时做普通钼靶摄片及乳腺导管造影摄片,并经临床和病理证实。导管造影表现的分类,无明显异常11例,占11.22%;单纯性导管扩张者14例,占14.29%;导管扩张伴炎症16例,占16.32%;导管扩张伴乳腺增生37例,占37.76%;导管内乳头状瘤16例,占16.33%;导管癌4例,占4.08%。所以乳腺导管造影术检查能够增加溢液性乳腺病的阳性检出率。     

乳头溢液174例诊治分析

目的探讨乳头溢液的溢液特点、诊断方法与手术结果。方法对174例乳头溢液病例的溢液性质、术前检查方法、手术术式以及术后病理结果进行回顾性分析。结果174例乳头溢液中,单孔的血性溢液（或浆液性溢液）118例（67．82％）。术前造影显示乳导管内占位性病变160例,乳导管造影诊断符合率85．00％。结论在乳头溢液中,单孔的血性溢液（或浆液性溢液）最有临床价值。选择性乳导管造影仍然是一种简便、可靠的检查方法。     

乳腺导管造影技术在非哺乳期乳头溢液检查中的质量控制

目的:探讨乳腺导管造影技术在非哺乳性溢液检查中的质量控制。方法:对106例非哺乳性溢液的女性患者行乳腺导管造影。并对多乳眼溢液行多次乳腺导管造影检查。结果:106例中,93例造影成功,技术成功率87.7%。42例为导管占位性病变,阳性率45.2%。结论:乳腺导管造影方法在非哺乳性溢液患者的检查中是一个既简单又安全的方法,在乳腺导管系统疾病的诊断和鉴别诊断中起到了重要作用。     

Conventional galactography and MR contrast galactography for diagnosing nipple discharge: preliminary results

OBJECTIVE: We wanted to compare the clinical usefulness of conventional galactography and MR contrast galactography for diagnosing patients with nipple discharge. MATERIALS AND METHODS: Both conventional galactography and MR contrast galactography were performed prospectively in 16 patients. Gadopentate dimeglumine (0.1 ml) was mixed with non-ionic contrast medium (0.9 ml) to obtain a resultant volume of 1 ml and this was used for both examinations. Following conventional galactography, MR contrast galactography was performed after direct injection of contrast media into the duct. RESULTS: Conventional galactography and MR contrast galactography were concordant in 13 (81%) of 16 patients; the results were normal in five, ductal dilatation was noted in four and intraductal filling defects were noted in four. The remaining three (19%) patients demonstrated discordant findings on the two examinations. While conventional galactography revealed filling defects, the MR contrast galactography results were normal in two patients. The third patient had kinks-stricture on conventional galactography and MR contrast galactography showed ductal dilatation. This suggested there were false positive results for the three patients' conventional galactography, and all the three patients with discordant results underwent surgery and the histopathologic evaluation showed fibrocystic changes. CONCLUSION: MR contrast galactography may be used as an alternative imaging modality for making the diagnosis of pathologic nipple discharge. However, statistically supported studies with large pools of subjects for comparing the galactography and MR contrast galactography results are needed to confirm our findings.     

自制探针对乳腺导管造影作用的探讨

目的探讨自制探针在乳腺导管造影中的作用。方法探针组导管造影45例,与常规组56例患者进行比较,记录患者出现疼痛以及导管损伤和检查成功的例数。结果使用探针组45例患者有2例出现疼痛,无导管损伤,43例检查成功;常规组56例有15例出现疼痛,并有3例伴有导管损伤,检查成功41例。结果经统计学处理,两组在疼痛率和成功率上的差异有显著意义。结论自制探针用于乳腺导管造影,可使患者的疼痛率大大减低,检查成功率明显增加,且无导管损伤,可以认为它在乳腺导管造影中起到很重要的作用。     

Technical innovation: wire guided ductography

To introduce an easy and improved technique for performing ductography using inexpensive easily available intravenous cannula. Guide wire: Prolene/Surgipro 3-0 (Polypropylene mono filament non-absorbable surgical suture). A plastic 26 G intravenous cannula. Disposable syringe 2 ml. Non-ionic contrast (low density like Omnipaque 240 mg I/I). The guide wire (Prolene 3-0) is introduced into the orifice of the duct heaving discharge and 26 G intravenous plastic cannula is then passed over the guide wire. The cannula is advanced in the duct over guide wire by spinning around it. When the cannula is in place the guide wire is removed. Any air bubbles present in the hub of the cannula can be displaced by filling the hub from bottom upwards with needle attached to contrast filled syringe. 0.2-0.4 ml non-ionic contrast is gently injected. Injection is stopped if the patient has pain or burning. Magnified cranio-caudal view is obtained with cannula tapped in place and gentle compression is applied with the patient sitting. If duct filling is satisfactory a 90* lateral view is obtained. A successful adaptation of the technique for performing ductography is presented. The materials required for the technique are easily available in most radiology departments and are inexpensive, thus making the procedure comfortable for the patient and radiologist with considerable cost effectiveness.     

乳腺导管造影定位加选择性区段切除治疗乳头溢液

目的 通过应用乳腺导管造影定位加选择性区段切除治疗乳头溢液。方法 对15例患先行乳头内置管，再行乳腺导管造影。术前应用美兰注入导管中，此时行选择性区段切除。结果 本组15例患均痊愈，随访2年均未见复发。结论 本术式简单，成功率高，对于推广应用有重要意义。     

Ultrasound-guided percutaneous galactography

We present a new percutaneous ultrasound-guided galactography technique that may be used in patients in whom the conventional technique fails and breast ultrasonography shows dilated ducts. © 1993 John Wiley & Sons, Inc.     

乳腺导管造影技术在非哺乳期乳头溢液中的应用

目的：探讨乳腺导管造影技术在非哺乳性溢液中的质量控制。方法：对106例非哺乳性溢液的女性患者行乳腺导管造影。并对多乳眼溢液行多次乳腺导管造影检查。结果：106例中93例造影成功，成功率为87．7％。42例为导管占位性病变，阳性率45．2％。结论：乳腺导管造影在非哺乳性溢液患者的检查中是一种简单安全的技术，在乳腺导管系统疾病的诊断和鉴别诊断中起到了重要作用。     

全数字化乳腺导管造影在乳头溢液性疾病中的应用

目的探讨全数字化乳腺导管造影在乳头溢液性疾病的应用价值。方法回顾分析121例经手术病理证实的全数字化乳腺导管造影与其常规钼靶X线片的影像学特征,结合病理学,对照诊断。结果全数字化乳腺导管造影影像学诊断：乳腺导管扩张症36例,导管内乳头状瘤43例,乳腺囊性增生病12例,乳腺导管扩张伴炎症9例,导管原位癌15例,浸润性导管癌6例。病理结果：乳腺导管扩张症36例,导管内乳头状瘤45例,乳腺囊性增生病10例,乳腺导管扩张伴炎症9例,导管原位癌14例,其中1例导管内癌伴早期浸润,浸润性导管癌6例。与病理诊断对照,全数字化乳腺导管造影的诊断正确率为96.7%。结论全数字化乳腺导管造影对乳头溢液性疾病的诊断,对良恶性的鉴别有重要的临床应用价值,能够为外科手术提供依据和手术路径。