title: Ultrasound elastography and magnetic resonance examinations are effective for the accurate diagnosis of mammary duct ectasia.
abstract: OBJECTIVE
  This study is to investigate the values of multiple quantitative evaluation parameters in the diagnosis of mammary duct ectasia (MDE), using real-time ultrasound elastography (UE) and magnetic resonance imaging (MRI).
  
  
  METHODS
  This retrospective study was performed on 15 patients (16 lesions) with MDE. Ultrasound examination was performed with the LOGIQ E9 ultrasound instrument, with all lesions being examined by routine ultrasound and UE. MRI examination was performed with a Signa HD × 3.0T TWINSP MR System, including of plain-scan, diffusion-weighted imaging, dynamic contrast-enhanced MRI, and proton magnetic resonance spectroscopy. Imaging features, as well as semi-quantitative and quantitative parameters, were analyzed to determine their diagnostic value for MDE.
  
  
  RESULTS
  According to the five-point scale in UE, twelve lesions belonged to 1-3 point scale, and four lesions were in 4-5 point scale, with an average of 2.93 ± 0.77. In dynamic contrast-enhanced MRI, the lesions appeared as obviously enhanced signals. The MRI early-enhancement rate ranged from 0.35 to 1.07 (0.67 ± 0.30 on average); the time peak ranged between 192 and 330 s (248 ± 37 s on average); the peak-enhancement ratio ranged from 2.26 to 3.06, with an average of 2.59 ± 0.33. According to MRI time-signal intensity curves classified into persistently enhancing (type I), plateau (type II) and washout (type III), 12 lesions (75%) belonged to type I, three (18.75%) belonged to type II, and one (6.25%) belonged to type III. Magnetic resonance spectroscopy showed that a total choline peak occurred only in one lesion. The diagnosis accuracy rates for ultrasound alone, MRI alone and the combination of ultrasound and MRI were 75% (12/16), 87.5% (14/16) and 93.75% (15/16), respectively.
  
  
  CONCLUSIONS
  Both ultrasound and MRI show clinical importance in MDE diagnosis. However, UE, dynamic contrast-enhanced MRI, and magnetic resonance spectroscopy demonstrate significantly better diagnosis and differential diagnosis of MDE.
authors: Department of Radiology, Division of Ultrasound, The Second Hospital of Shandong University Jinan City, Shandong Province, P.R. China.
authors: Feixue
authors: F
authors: Zhang
authors: Department of Radiology, Qilu Hospital, Shandong University Jinan City, Shandong Province, P.R. China.
authors: Dexin
authors: D
authors: Yu
authors: Department of Breast Surgery, The Second Hospital of Shandong University Jinan City, Shandong Province, P.R. China.
authors: Mingming
authors: M
authors: Guo
authors: Department of Radiology, Qilu Hospital, Shandong University Jinan City, Shandong Province, P.R. China.
authors: Qing
authors: Q
authors: Wang
authors: Department of Breast Surgery, The Second Hospital of Shandong University Jinan City, Shandong Province, P.R. China.
authors: Zhigang
authors: Z
authors: Yu
authors: Department of Breast Surgery, The Second Hospital of Shandong University Jinan City, Shandong Province, P.R. China.
authors: Fei
authors: F
authors: Zhou
authors: Department of Radiology, Qilu Hospital, Shandong University Jinan City, Shandong Province, P.R. China.
authors: Meng
authors: M
authors: Zhao
authors: Department of Radiology, Qilu Hospital, Shandong University Jinan City, Shandong Province, P.R. China.
authors: Feng
authors: F
authors: Xue
authors: Department of Radiology, The Second Hospital of Shandong University Jinan City, Shandong Province, P.R. China.
authors: Guangrui
authors: G
authors: Shao
keywords: Mammary duct ectasia; magnetic resonance imaging; magnetic resonance spectroscopy; ultrasound; ultrasound elastography