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

Yücesoy C, Oztürk E, Ozer Y, Edgüer T, Hekimoglu B - Korean J Radiol (2008 Sep-Oct)

Bottom Line: 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.The remaining three (19%) patients demonstrated discordant findings on the two examinations.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, S.B. Ankara Diskapi Training and Research Hospital, Ankara, Turkey. yucecun2000@yahoo.com

ABSTRACT

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.

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Related in: MedlinePlus

49-year-old woman with bloody discharge.A. Conventional galactography on craniocaudal projection shows irregular filling defects (arrow). Note duct is extended due to compression.B. MR contrast galactography on axial plane at same level shows no filling defects and pathology revealed fibrocyctic changes. Note duct is minimally heterogeneous, possibly as result of different degrees of hemorrhage mixed with contrast material.
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Figure 1: 49-year-old woman with bloody discharge.A. Conventional galactography on craniocaudal projection shows irregular filling defects (arrow). Note duct is extended due to compression.B. MR contrast galactography on axial plane at same level shows no filling defects and pathology revealed fibrocyctic changes. Note duct is minimally heterogeneous, possibly as result of different degrees of hemorrhage mixed with contrast material.

Mentions: Conventional galactography demonstrated filling defects in six patients (38%), ductal dilatation in four patients (25%), kinks and stricture in one patient (6%), and no abnormal finding in five (31%). On the other hand, MRCG revealed ductal dilation in five patients (31%), normal ductal pattern in seven (44%), and filling defects in the remaining four patients (25%). On comparing the results obtained on both examinations of the 16 patients, there was a consensus for 13 patients (81%) and discordance for three patients (19%) (Table 1). While CG revealed filling defects, the MRCG was interpreted by one of the radiologists that two of the patients within the discordant group were normal (Fig. 1) and the other case that was reported as kinks-stricture on CG and showed ductal dilatation on the MRCG.


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

Yücesoy C, Oztürk E, Ozer Y, Edgüer T, Hekimoglu B - Korean J Radiol (2008 Sep-Oct)

49-year-old woman with bloody discharge.A. Conventional galactography on craniocaudal projection shows irregular filling defects (arrow). Note duct is extended due to compression.B. MR contrast galactography on axial plane at same level shows no filling defects and pathology revealed fibrocyctic changes. Note duct is minimally heterogeneous, possibly as result of different degrees of hemorrhage mixed with contrast material.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627215&req=5

Figure 1: 49-year-old woman with bloody discharge.A. Conventional galactography on craniocaudal projection shows irregular filling defects (arrow). Note duct is extended due to compression.B. MR contrast galactography on axial plane at same level shows no filling defects and pathology revealed fibrocyctic changes. Note duct is minimally heterogeneous, possibly as result of different degrees of hemorrhage mixed with contrast material.
Mentions: Conventional galactography demonstrated filling defects in six patients (38%), ductal dilatation in four patients (25%), kinks and stricture in one patient (6%), and no abnormal finding in five (31%). On the other hand, MRCG revealed ductal dilation in five patients (31%), normal ductal pattern in seven (44%), and filling defects in the remaining four patients (25%). On comparing the results obtained on both examinations of the 16 patients, there was a consensus for 13 patients (81%) and discordance for three patients (19%) (Table 1). While CG revealed filling defects, the MRCG was interpreted by one of the radiologists that two of the patients within the discordant group were normal (Fig. 1) and the other case that was reported as kinks-stricture on CG and showed ductal dilatation on the MRCG.

Bottom Line: 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.The remaining three (19%) patients demonstrated discordant findings on the two examinations.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, S.B. Ankara Diskapi Training and Research Hospital, Ankara, Turkey. yucecun2000@yahoo.com

ABSTRACT

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.

Show MeSH
Related in: MedlinePlus