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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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54-year-old woman with bloody discharge.A. Conventional galactography on craniocaudal projection demonstrates dilated ducts and filling defects (arrows).B. MR contrast galactography on axial plane shows hyperintense dilated ducts and hypointense multiple filling defects (arrows). Pathology revealed intraductal papillomas.
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Figure 2: 54-year-old woman with bloody discharge.A. Conventional galactography on craniocaudal projection demonstrates dilated ducts and filling defects (arrows).B. MR contrast galactography on axial plane shows hyperintense dilated ducts and hypointense multiple filling defects (arrows). Pathology revealed intraductal papillomas.

Mentions: Surgery was performed on 11 of the 16 cases. The surgeon was informed preoperatively about the results of both examinations. Histological review demonstrated fibrocystic changes in seven patients, intraductal papilloma in three and normal findings in one patient. All the patients with papillomas that were postoperatively confirmed via the pathological evaluation results were in the group of patients with concordant results, and both CG and MRCG revealed filling defects (Figs. 2, 3).


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)

54-year-old woman with bloody discharge.A. Conventional galactography on craniocaudal projection demonstrates dilated ducts and filling defects (arrows).B. MR contrast galactography on axial plane shows hyperintense dilated ducts and hypointense multiple filling defects (arrows). Pathology revealed intraductal papillomas.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: 54-year-old woman with bloody discharge.A. Conventional galactography on craniocaudal projection demonstrates dilated ducts and filling defects (arrows).B. MR contrast galactography on axial plane shows hyperintense dilated ducts and hypointense multiple filling defects (arrows). Pathology revealed intraductal papillomas.
Mentions: Surgery was performed on 11 of the 16 cases. The surgeon was informed preoperatively about the results of both examinations. Histological review demonstrated fibrocystic changes in seven patients, intraductal papilloma in three and normal findings in one patient. All the patients with papillomas that were postoperatively confirmed via the pathological evaluation results were in the group of patients with concordant results, and both CG and MRCG revealed filling defects (Figs. 2, 3).

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