MR对乳头溢液的诊断价值

目的:对比乳腺MR、钼靶和超声检查对乳头溢液的诊断价值。方法:对11例因乳头溢液在中山大学附属肿瘤医院就诊的患者进行前瞻性的研究。所有患者均行平扫及动态增强MR扫描、钼靶及超声检查,都做了导管造影,其中4例因各种原因导管造影失败,其余7例均行导管造影检查;11例患者均行手术,恶性者行改良根治术,良性者行乳腺区段切除术。结果:在11例患者的24个病灶中,MR的图象与最后的组织病理学结果均有关联性。MR图象正确诊断出纤维腺瘤3个,乳腺癌3个,导管内乳头状瘤11个,纤维囊性乳腺病5个,小叶增生1个,误诊硬化性腺病为乳腺癌1个,诊断准确率为95.8%(22/24)。而钼靶、导管造影和超声的诊断准确率均低于50%(5/24,12/24及8/24)。结论:乳腺MR检查能鉴别良恶性乳头溢液,提供了一种非侵入性的乳腺导管造影的方法。

Diagnosis of MR for patients with nipple discharge

OBJECTIVE:To investigate the potential of magnetic resonance (MR) imaging in patients with nipple discharge by contrast of mammography, galactography and ultrasonic. METHODS: Eleven patients with nipple discharge underwent a prospective research. All patients underwent magnetic resonance scanning, mammography and ultrasonic inspection. Galactography was attempted in all patients, in whom 4 cases failed, and the other 7 cases succeed. Operations were performed on all 11 patients, in which modified radical mastectomy for malignant focus and segmental mastectomy for benign focus. RESULTS: In all 24 focuses of 11 patients who underwent the operation, MR imaging findings correlated with histopathologic findings. MR imaging correctly demonstrated three fibroadenomas, three breast cancers, eleven benign papillomas, five fibrocystic diseases of breast and one lobulated hyperplasia, and falsely demonstrated a sclerosing adenosis as a breast cancer. The veracity of MR was 95.8%(22/24). The veracity of mammography, galactography and ultrasonic inspection was all under 50%(5/24, 12/24,8/24). CONCLUSION: MR imaging can help identify both benign and malignant causes of nipple discharge. It potentially offers a noninvasive alternative to galactography.