高频超声与乳管镜诊断病理性乳头溢液对比分析

Comparative analysis of high-frequency ultrasound and fiberoptic ductoscopy in pathological nipple discharge

目的评价高频超声和乳管镜对病理性乳头溢液的诊断准确率。方法收集我院收治的122例(146侧病变)病理性乳头溢液患者,全部行高频超声和乳管镜检查,以病理诊断为标准,对比分析两者的诊断准确率。结果 146侧病变中,恶性病变8侧,超声均诊断正确,乳管镜诊断7侧,漏诊1侧;良性病变138侧,超声正确诊断108侧,乳管镜正确诊断116侧;高频超声和乳管镜的诊断准确率分别为79.45%(116/146)、84.25%(123/146),差异无统计学意义(χ2=1.13,P>0.05)。高频超声联合乳管镜检查准确率为95.89%(140/146),与单独高频超声或乳管镜检查比较,差异有统计学意义(χ2=14.00,P<0.01)。结论高频超声与乳管镜对病理性乳头溢液均有很高的诊断价值,超声对伴乳腺导管扩张的乳头溢液有很好的定性、定位诊断价值,且无创,可作为乳头溢液患者的首选检查方法;对超声检查未发现病因者,必要时再结合乳管镜检查,以减少漏诊。

Objective To investigate the accuracy of high-frequency ultrasound and fiberoptic ductoscopy in pathological nipple discharge. Methods Totally 122 patients （146 sides） with pathological nipple discharge were examined with fiber- optic ductoscopy and high-frequency ultrasound. The diagnostic accuracy of both methods was compared with pathology. Results In the 146 side of lesions, there were 8 malignant lesions, which were all correct diagnosis with ultrasound while ductoscopy missed 1; and there were 138 benign lesions, of which 108 were correct diagnosis with ultrasound and 116 were correctly diagnosed with ductoscopy. The diagnostic accuracy of high-frequency ultrasound and fiberoptic ductoscopy was 79.45% （116/146） and 84. 25% （123/146）, which had no statistical significance （χ2 =1.13, P〉0. 05）. The diagnostic accuracy of high-frequency ultrasound combined with fiberoptic ductoscopy was 95.89 %（140/146）, which had statistical difference compared with high frequency ultrasound and fiberoptic ductoscopy （χ2 = 14.00, P〈0.01）. Conclusion Both high-frequency ultrasound and fiberoptic ductoscopy have high diagnostic accuracy for pathological nipple discharge. High- frequency ultrasound can qualitatively diagnose and locate the intraductal lesions, which is non-invasive, painless, and can be used as preferred inspection method for pathological nipple discharge. If the ultrasound result is negative, it is necessary to further combine ductoscopy to reduce misdiagnosis.