乳头溢液性疾病的超声征象与乳管内窥镜检查结果的对比分析

目的 评价超声对乳头溢液性疾病的临床诊断价值.方法 对57例乳头溢液性疾病患者分别行超声和乳管内窥镜检查,将超声征象与乳管镜结果进行对比分析.结果 超声对乳头溢液性疾病阳性征象诊断率为96.49%:导管扩张27例(47.36%),实性肿物伴导管扩张或囊肿19例(33.33%),囊性回声6例(10.52%),实性回声3例(5.26%),超声无异常征象2例(3.51%).乳管镜诊断:乳腺导管炎26例(45.61%),导管扩张症12例(21.05%),导管内乳头状瘤或乳头状瘤病17例(29.82%),乳腺癌2例(3.50%).超声对实性病变的诊断敏感性为52.63%,特异性为89.47%,误诊率为10.50%,漏诊率为47.36%.结论 超声对乳头溢液性疾病有较高的敏感性,但对此类疾病中实性病变的漏误诊率较高.

Sonographic findings compared with fiberoptic ductoscopy in the patients of spontaneous nipple discharge

Objective To investigate the ultrasound diagnostic value for nipple discharge disease by comparison with fiberoptic ductoscopy. Methods Fiberoptic ductoscopy and ultrasonic inspection were performed on fifty-seven patients with spontaneous nipple discharge,and the results were analysed. Results In all patients, 55 cases (96. 49 % ) were abnormal in high-frequency ultrasound inspection:27 mammary duct expansion(47.36%),19 occupying lesion with mammary duct expansion or cyst (33.33%),6 cystic echo ( 10. 52% ) ,3 only solid echopattern (5.26%) ,and 2 nothing found (3.51% ). In ultrasonic inspection,color and pulse Doppler signal were found in 7 cases. On the other hand, 26 galactophoritis (45.61%), 12mammary duct ectasia (21.05 %), 17 intraductal papilloma (29.82%), 2 breast carcinoma (3.50%) were diagnosed by fiberoptic ductoscopy. In all 19 cases with occupying lesion,ultrasonography's sensitivity was 52. 63% ,specificity was 89. 47%, misdiagnosis rate was 10. 50%, rate of missed diagnosis was 47.36%.Conclusions To nipple discharge disease, high-frequency ultrasound has high sensitivity, easy to find abnormal indication,but is not accurate enough in the diagnosis of smaller occupying lesion.