磁振造影之3D乳管成像對乳頭分泌物患者之臨床應用－病例報告

3D Breast Duct Imaging Of Magnetic Resonance Imaging In Patients With Nipple Secretions-Case Report

李滿芳(Man-Fang Li) ； 吳彥潔(Yen-Chien Wu) ； 李曉玲(Hsiao Ling Lee) ； 曾櫻綺(Ying-Chi Tseng)

《臺灣醫事放射期刊》 9卷2期 (2021/12) Pp. 22-26

https://doi.org/10.6717/JTMRT.202112_9(2).0004

摘要

病理性乳頭分泌物為乳管病變所引發症狀之一，臨床上常用乳管攝影的方式對乳管病灶處進行定位，以供乳房外科醫生進行手術切片，用以確認病灶處為良性病變抑或是惡性腫瘤。本次報告為49歲女性，進行乳管攝影的方式定位失敗，進而使用磁振造影（Magnetic Resonance Imaging，MRI）的方式，獲得乳管的3D定位影像。運用此3D影像，輔助訂位以進行外科手術切片，並順利取得病理結果。MRI之3D乳管成像相較於乳管攝影有不需注射對比劑、不會產生游離輻射，患者沒有壓迫乳房的疼痛感等優勢，可於適當時機取代乳管攝影。

關鍵字

病理性乳頭分泌物（Pathologic Nipple Discharge, PND） ； 乳管攝影（Ductography） ； 磁振造影（Magnetic Resonance Imaging, MRI）

並列摘要

Pathological nipple discharge is one of the most common symptoms caused by breast duct lesions. In clinical practice, a surgeon performs surgical biopsies to locate breast lesion using breast ductography. However, it may sometimes fail to identify lesion position due to the obstruction of ductography. Another imaging modality, Magnetic Resonance Imaging (MRI), is sensitive to fluid signal, may provide an alternative method to visualize the position of breast duct. Therefore, we apply a high-resolution MRI on a 49-year-old woman who failed to locate the breast duct using breast ductography. Our result shows that breast duct is successfully identified with the use of high-resolution 3D breast duct MRI and it is helpful to surgeon to conduct surgical biopsies. Moreover, compared with conventional breast ductography, 3D MRI provides the additional advantages including no contrast agent injection needed, non-ionizing radiation, and free of pain as no need for compressing breast. In conclusion, 3D breast duct MRI may provide an alternative way when breast ductography is not possible.

並列關鍵字

Pathologic Nipple Discharge ； Ductography ； Magnetic Resonance Imaging