Siegfried A. Schwab, Presenter: Nothing to Disclose

Evelyn Wenkel, Abstract Co-Author: Nothing to Disclose

Rolf Janka MD, PhD, Abstract Co-Author: Nothing to Disclose

Katja Melzer, Abstract Co-Author: Nothing to Disclose

Rüdiger Schulz-Wendtland MD, Abstract Co-Author: Nothing to Disclose

Michael Uder MD, Abstract Co-Author: Speakers Bureau, Bracco Group Speakers Bureau, Bayer AG Research Consultant, Insight Agent Research Consultant, General Electric Company Research grant, Siemens AG Research grant, Koninklijke Philips Electronics NV

To evaluate the clinical value of direct magnetic resonance galactography (dMRG) in combination with magnetic resonance mammography (MRM) compared to conventional galactography (CGal) in patients with pathological nipple discharge.

31 women (age range 30 - 85 years) were included in the study and underwent clinical examination, mammography, CGal, sonography and cytology of the discharge. A standard MRM protocol was performed before or after the dMRG. The dMRG consists of a sagittal T1-weighted 3D FLASH (fast low angle shot) sequence. CGal and dMRG were blinded and analyzed independently in random order. The duct orientation in the breast was defined by dividing the breast in 12 sections analogous to a clock face. The depth of the pathology in the breast was measured from the nipple towards the chest wall. All patients underwent breast surgery.

One woman was excluded from the evaluation because ductal filling was not possible. Histology revealed benign findings in 23/30 women and malignant findings in 7/30 women. There was no difference in the evaluation of the CGal and the dMRG between examiner 1 and 2 regarding duct position and depth of the pathology. Comparing CGal and dMRG both examiners had different results in 7 patients. In 6 patients it was caused by a different ductal filling status in CGal and dMRG. In one woman a different ducts were filled in dMRG and CGal. In 8 patients the surgical procedure was modified due to the results of dMRG and MRM.

DMRG in combination with MRM allows localizing the pathological duct preoperatively comparable to CGal and allows localizing the extent of the pathology responsible for the nipple discharge before surgery.

DMRG in combination with MRM has the potential to become an alternative method to CGal in the in the diagnostic workup of pathological nipple discharge.

Schwab, S, Wenkel, E, Janka, R, Melzer, K, Schulz-Wendtland, R, Uder, M, Does Direct MR Galactography Have the Potential to Become an Alternative Diagnostic Tool in Patients with Pathological Nipple Discharge?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8002891.html