Korean J Radiol.  2008 Oct;9(5):426-431. 10.3348/kjr.2008.9.5.426.

Conventional Galactography and MR Contrast Galactography for Diagnosing Nipple Discharge: Preliminary Results

• Yucesoy C
• Ozturk E
• Ozer Y
• Edguer T
• Hekimoglu

• KMID: 1385401
• DOI: http://doi.org/10.3348/kjr.2008.9.5.426

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.

Keyword

Breast; Galactography; Nipple discharge; Magnetic resonance (MR)

MeSH Terms

Adult
Aged
Breast Diseases/*diagnosis/pathology/radiography
Contrast Media
Exudates and Transudates
Female
Gadolinium DTPA/diagnostic use
Humans
Magnetic Resonance Imaging/*methods
Middle Aged
Nipples/*secretion
Prospective Studies

Figure

• 

  Fig. 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.

• 

  Fig. 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.

• 

  Fig. 3 33-year-old woman with bloody discharge.A, B. Both conventional galactography (A) and MR contrast galactography (B) reveal filling defects (arrows) and pathology results were reported as intraductal papillomas.

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