Dual contrast-enhanced ultrasound for diagnosing pathologic nipple discharge associated with papillary lesions

Abstract Background The goal of this research study is to determine the efficacy of dual contrast-enhanced ultrasound (US) in evaluating ductal papillary lesions associated with pathological nipple discharge. Methods A prospective multicenter study was conducted between January 2020 and December 202...

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Main Authors: Yanchun Zhao, Songsong Wu, Zhongtao Bao, Yucheng Lin, Ziwei Xu, Xing Chen, Lingpeng Tang, Guorong Lyu
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Medical Imaging
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Online Access:https://doi.org/10.1186/s12880-025-01674-5
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author Yanchun Zhao
Songsong Wu
Zhongtao Bao
Yucheng Lin
Ziwei Xu
Xing Chen
Lingpeng Tang
Guorong Lyu
author_facet Yanchun Zhao
Songsong Wu
Zhongtao Bao
Yucheng Lin
Ziwei Xu
Xing Chen
Lingpeng Tang
Guorong Lyu
author_sort Yanchun Zhao
collection DOAJ
description Abstract Background The goal of this research study is to determine the efficacy of dual contrast-enhanced ultrasound (US) in evaluating ductal papillary lesions associated with pathological nipple discharge. Methods A prospective multicenter study was conducted between January 2020 and December 2022. All participants were examined using dual contrast-enhanced US and had re-adjustment of BI-RADS classification. Genuine ductal papillary lesions were identified using US features and subsequently subjected to biopsy or excision. Using pathological results and clinical follow-up as the reference standard as a standard reference, we compared the diagnostic efficacy of dual contrast-enhanced US to conventional US in detecting papillary lesions. Results The study included 102 female participants ranging in age from 29 to 80 years (average 47.6 ± 9.4), of whom 87 were retained for analysis. We precisely localized discharging ducts with papillary lesions in 85 patients, with 68 showing varying degrees of enhancement in papillary lesions. Compared to conventional US, dual contrast-enhanced US was more accurate in locating and detecting papillary lesions (P < 0.001). The optimized BI-RADS classification allowed for a more informed prediction of the malignancy risk associated with papillary lesions. Multivariate logistic regression analysis revealed that ductal continuity, the boundary between the nodule and duct, and peak intensity are independent risk factors for malignancy. The area under the curve for detecting malignant papillary lesions was 0.937. Conclusions Dual contrast-enhanced US is effective at precisely locating lactiferous ducts in pathological nipple discharge, detecting and differentiating papillary lesions, and improving the accuracy of BI-RADS classification.
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spelling doaj-art-3ca3a120cdef478690fa1aa6e86e16ad2025-08-20T03:15:10ZengBMCBMC Medical Imaging1471-23422025-04-0125111110.1186/s12880-025-01674-5Dual contrast-enhanced ultrasound for diagnosing pathologic nipple discharge associated with papillary lesionsYanchun Zhao0Songsong Wu1Zhongtao Bao2Yucheng Lin3Ziwei Xu4Xing Chen5Lingpeng Tang6Guorong Lyu7Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical UniversityDepartment of Ultrasonography, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Ultrasound, The First Affiliated Hospital of Fujian Medical UniversityDepartment of Medical Ultrasonics, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Maternity and Child Health Hospital, Fujian Medical UniversityDepartment of Ultrasonography, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Basic Surgery, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Ultrasonography, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Ultrasound, The Second Affiliated Hospital of Fujian Medical UniversityAbstract Background The goal of this research study is to determine the efficacy of dual contrast-enhanced ultrasound (US) in evaluating ductal papillary lesions associated with pathological nipple discharge. Methods A prospective multicenter study was conducted between January 2020 and December 2022. All participants were examined using dual contrast-enhanced US and had re-adjustment of BI-RADS classification. Genuine ductal papillary lesions were identified using US features and subsequently subjected to biopsy or excision. Using pathological results and clinical follow-up as the reference standard as a standard reference, we compared the diagnostic efficacy of dual contrast-enhanced US to conventional US in detecting papillary lesions. Results The study included 102 female participants ranging in age from 29 to 80 years (average 47.6 ± 9.4), of whom 87 were retained for analysis. We precisely localized discharging ducts with papillary lesions in 85 patients, with 68 showing varying degrees of enhancement in papillary lesions. Compared to conventional US, dual contrast-enhanced US was more accurate in locating and detecting papillary lesions (P < 0.001). The optimized BI-RADS classification allowed for a more informed prediction of the malignancy risk associated with papillary lesions. Multivariate logistic regression analysis revealed that ductal continuity, the boundary between the nodule and duct, and peak intensity are independent risk factors for malignancy. The area under the curve for detecting malignant papillary lesions was 0.937. Conclusions Dual contrast-enhanced US is effective at precisely locating lactiferous ducts in pathological nipple discharge, detecting and differentiating papillary lesions, and improving the accuracy of BI-RADS classification.https://doi.org/10.1186/s12880-025-01674-5Nipple dischargeContrast-enhanced ultrasonographyPapillary lesionDiagnostic efficacy
spellingShingle Yanchun Zhao
Songsong Wu
Zhongtao Bao
Yucheng Lin
Ziwei Xu
Xing Chen
Lingpeng Tang
Guorong Lyu
Dual contrast-enhanced ultrasound for diagnosing pathologic nipple discharge associated with papillary lesions
BMC Medical Imaging
Nipple discharge
Contrast-enhanced ultrasonography
Papillary lesion
Diagnostic efficacy
title Dual contrast-enhanced ultrasound for diagnosing pathologic nipple discharge associated with papillary lesions
title_full Dual contrast-enhanced ultrasound for diagnosing pathologic nipple discharge associated with papillary lesions
title_fullStr Dual contrast-enhanced ultrasound for diagnosing pathologic nipple discharge associated with papillary lesions
title_full_unstemmed Dual contrast-enhanced ultrasound for diagnosing pathologic nipple discharge associated with papillary lesions
title_short Dual contrast-enhanced ultrasound for diagnosing pathologic nipple discharge associated with papillary lesions
title_sort dual contrast enhanced ultrasound for diagnosing pathologic nipple discharge associated with papillary lesions
topic Nipple discharge
Contrast-enhanced ultrasonography
Papillary lesion
Diagnostic efficacy
url https://doi.org/10.1186/s12880-025-01674-5
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