{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T03:15:47Z","timestamp":1770693347167,"version":"3.49.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"1177","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the auxiliary role of contrast-enhanced ultrasound (CEUS) in the etiological diagnosis of pathological nipple discharge (PND) and compare its effectiveness with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study conducted from March 2021 to February 2024, PND patients underwent breast ultrasound and DCE-MRI after initial history and physical examination. Lesions were categorized as mass or non-mass-like on baseline US and assessed for vascularity using colour Doppler. CEUS was utilized to refine the breast imaging reporting and data system (BI-RADS) classification. Logistic regression identified risk factors, and diagnostic performance was evaluated using receiver operating characteristic curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 116 lesions from 112 PND patients were analysed. CEUS-assisted ultrasound showed increased specificity (ranging from 50.0%-80.0% compared to US alone, P\u2009=\u2009.009) while maintaining sensitivity. Of the 81 patients who underwent DCE-MRI, CEUS demonstrated a higher positive predictive value (83.3% vs 75.5%), with comparable negative predictive values (97.0% vs 96.4%). CEUS was particularly effective in accurately diagnosing benign lesions that were overestimated by DCE-MRI and in identifying ductal carcinoma in situ with greater precision than US alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The auxiliary use of CEUS with ultrasound improves the specificity and positive predictive value in diagnosing PND-associated malignancies and serves as a valuable secondary imaging method to DCE-MRI, potentially reducing unnecessary biopsies of benign lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>CEUS can enhance the diagnostic accuracy of PND, effectively differentiating benign from malignant lesions, and its integration into clinical practice could offer significant benefits in patient management.<\/jats:p>\n   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