超声乳管造影联合亚甲蓝染色在乳头溢液手术中的可行性研究

Feasibility study of ultrasound mammography combined with methylene blue staining in the operation of nipple discharge

目的分析超声乳管造影联合亚甲蓝染色在乳头溢液手术中的可行性。方法回顾性选取2019年1月至2021年12月38例乳头溢液患者,均行钼靶乳管造影和超声乳管造影检查,术前12 h联合亚甲蓝染色;观察术中亚甲蓝染色率、造影方法的影像显影及病变位置分布。采用统计学软件SPSS 22.0进行数据分析,计数资料用[例(%)]表示,组间比较采用χ^(2)检验;ROC曲线分析超声乳管造影和钥靶乳管造影对乳头溢液的诊断价值。P<0.05表示差异有统计学意义。结果38例患者经常规超声检查共发现44处病灶,术中亚甲蓝染色率为100%,以术后组织病理学检查结果为金标准,结果显示超声乳管造影的准确度显著高于钼靶乳管造影(93.2%vs.75.0%),假阴性率显著低于钼靶乳管造影(5.0%vs.22.5%),差异均有统计学意义(P<0.05)。超声乳管造影诊断乳头溢液的AUC为0.867,高于钼靶乳管造影(0.766)。结论超声乳管造影联合亚甲蓝染色可对溢液乳管进行术前定位,明确病变位置,提高乳头溢液的检出率,同时可精准切除病灶,减少对正常乳腺组织的损伤。

Objective To analyze the feasibility of ultrasound mammography combined with methylene blue staining in the operation of nipple discharge.Methods A total of 38 patients with nipple discharge from January 2019 to December 2021 were retrospectively selected.All of them underwent mammography and ultrasound mammography,combined with methylene blue staining 12 h before surgery.The methylene blue staining rate,imaging development and lesion location were observed.Statistical software SPSS 22.0 was used for data analysis.The counting data were represented by[n(%)],and the comparison between groups was performed by χ^(2) test.ROC curve was used to analyze the diagnostic value of ultrasound and mammography in nipple discharge.P<0.05 indicated that the difference was statistically significant.Results A total of 44 lesions were found by routine ultrasonography in 38 patients,and the methylium-blue staining rate was 100%.The results of postoperative histomatological examination were used as the gold standard.The results showed that the accuracy of ultrasonography was significantly higher than that of mammography(93.2%vs.75.0%).The false negative rate was significantly lower than that of mammography(5.0%vs.22.5%),and the differences were statistically significant(P<0.05).The AUC for the diagnosis of nipple discharge by ultrasonography was 0.867,which was higher than that by mammography(0.766).Conclusion Ultrasonography combined with methylene blue staining can locate the leaking milk duct before surgery,identify the lesion location,improve the detection rate of nipple discharge,and accurately remove the lesion to reduce the damage to normal breast tissue.