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Ductography by prof j venkat
Ductography is a specialized imaging technique for evaluating breast ducts, often used to diagnose conditions like intraductal papillomas and abnormal nipple discharge. The document details the anatomy of the breast, indications, contraindications, required equipment and materials, and the procedural steps involved in ductography. Additionally, it discusses potential findings, complications, and post-procedural care.
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Ductography by prof j venkat
- 1. DUCTOGRAPHY By Prof JVenkat Professor in Radiography Chennai India +919444923675 WhatsApp venkatdgr8@gmail.com SPECIAL PROCEDURE SERIES IN RADIOGRAPHY
- 2. OBJECTIVE • Definition • Anatomy •Indications • Contraindications • Equipment needed • Materials needed • Contrast media • Preparation • Procedure • Filming • Positive findings • Complications • Post procedural care/Instructions By Prof J Venkat Professor in Radiography Chennai India
- 3. • Ductography isa special type of contrast enhanced mammography used for imaging the breast ducts. • Ductography can aid in diagnosing the cause of an abnormal nipple discharge and is valuable in diagnosing intraductal papillomas and other conditions. • It is also called as Galactography or Ductogalactography DEFINITION - DUCTOGRAPHY By Prof J Venkat Professor in Radiography Chennai India
- 4. ANATOMY • Each breasthas 15 to 20 sections, called lobes. • Each lobe has many smaller structures called lobules. These end in dozens of tiny bulbs that can produce milk. • The lobes, lobules, and bulbs are all linked by thin tubes called ducts. • These ducts lead to the nipple in the center of a dark area of skin called the areola. • Fat fills the spaces between lobules and ducts. • There are no muscles in the breast, but muscles lie under each breast and cover the ribs. By Prof J Venkat Professor in Radiography Chennai India
- 5. INDICATIONS • Any Dischargefrom single duct • Blood discharge from any duct • Lesion involving duct • DCIS ( Ductal Carcinoma In Situ ) • Now obsolete, because of high quality Mammography and MR ductography By Prof J Venkat Professor in Radiography Chennai India
- 6. CONTRAINDICATIONS • Allergy toContrast media • Multiductal discharge By Prof J Venkat Professor in Radiography Chennai India
- 7. EQUIPMENT NEEDED • MammographyUnit By Prof J Venkat Professor in Radiography Chennai India
- 8. MATERIALS NEEDED • Gloves •Dilators • Rabinov sialography catheter or Venflon • Connecting tube • Plaster • 10 CC syringe • Dressing tray • Gauze • Cotton • Cups • Forceps • Blade handle • Kidney tray Picture from Techniques in Diagnostic Imaging Edited by Graham H. White House and Brian s. Worthington By Prof J Venkat Professor in Radiography Chennai India
- 9. CONTRAST MEDIA • Watersoluble Iodinated contrast • Non-Ionic or Ionic Contrast media • Iohexol 240mg I/mL • Omnipaque • Contrapaque • Dosage 0.5 -1ml , until patient feel fullness or pain By Prof J Venkat Professor in Radiography Chennai India
- 10. PREPARATION • Patient askedto remove all metal ornaments around head and neck • Nil oral for 4 hours • Patient asked to remove the cloths and wear hospital gown • IV line should be ready • Blood tests report should be available • Informed consent to be obtained. By Prof J Venkat Professor in Radiography Chennai India
- 11. PROCEDURE – INSHORT • Patient lie down on the table in supine • The origin of Duct is identified and wiped with gauze • The orifice slightly massaged and look for a bead of blood or discharge • Catheter filled with contrast inserted into orifice • Catheter taped at with plaster • Various view taken during injection of the contrast By Prof J Venkat Professor in Radiography Chennai India
- 12. PROCEDURE • Before cannulation,a craniocaudal subareolar magnification view is obtained and assessed for suspicious calcifications or masses. • Gentle periareolar pressure is used to elicit discharge. • This area is known as the “trigger point” or “trigger zone” By Prof J Venkat Professor in Radiography Chennai India
- 13. • Testing forthe presence of blood is useful to identify suspicious discharge ; a standard test strip may be used By Prof J Venkat Professor in Radiography Chennai India
- 14. • First, thenipple is gently cleansed and sterilized • with an alcohol swab to loosen and remove dried secretions with Betadine • Then, the tip of the cannula is placed on the orifice By Prof J Venkat Professor in Radiography Chennai India
- 15. • If necessary,the nipple may be stabilized between the thumb and forefinger By Prof J Venkat Professor in Radiography Chennai India
- 16. • The cannulais seamlessly attached to a 1–3-mL syringe filled with full-strength of Contrast without air bubble By Prof J Venkat Professor in Radiography Chennai India
- 17. • The cannulais secured with Micropore tape. • A volume of 0.2–0.3 ml of contrast material is slowly administered. If pain begins, stop By Prof J Venkat Professor in Radiography Chennai India
- 18. FILMING • A singlecraniocaudal digital spot magnification view is obtained with Mammography machine If necessary additional views such as MLO taken By Prof J Venkat Professor in Radiography Chennai India
- 19. FILMING A single craniocaudaldigital spot magnification view is obtained with Mammography machine • CC View • MLO View By Prof J Venkat Professor in Radiography Chennai India
- 20. POSITIVE FINDINGS DUCTAL ECTASIA.CRANIOCAUDAL DUCTOGRAM SHOWS A DILATED DUCTAL SYSTEM. FIBROCYSTIC CHANGES. NINETY-DEGREE MEDIOLATERAL DUCTOGRAM SHOWS CYSTS COMMUNICATING WITH THE DUCTAL SYSTEM. By Prof J Venkat Professor in Radiography Chennai India
- 21. POSITIVE FINDINGS CRANIOCAUDAL DUCTOGRAMSHOWS CONCOMITANT FIBROCYSTIC CHANGES (BLACK ARROW, AND A PAPILLOMA (WHITE ARROW) NINETY-DEGREE MEDIOLATERAL DUCTOGRAM SHOWS A FILLING DEFECT (ARROWS) WITHIN DILATED DUCTS, WHICH REPRESENTS A PAPILLOMA.. By Prof J Venkat Professor in Radiography Chennai India
- 22. POSITIVE FINDINGS CARCINOMA. CRANIOCAUDALDUCTOGRAM SHOWS LARGE FILLING DEFECTS NEAR THE NIPPLE (ARROW). CARCINOMA IN A PATIENT, MAGNIFIED CRANIOCAUDAL DUCTOGRAM BETTER SHOWS THE FILLING DEFECTS WITHIN THE DILATED DISTAL DUCTAL SYSTEM (BLACK ARROW) By Prof J Venkat Professor in Radiography Chennai India
- 23. COMPLICATIONS • Craniocaudal ductogram showsimmediate extravasation (arrow). By Prof J Venkat Professor in Radiography Chennai India
- 24. ARTEFACTS • Air bubbles. •Craniocaudal ductogram shows dark air bubbles (straight arrows) within contrast material, which were inadvertently administered. • Note the air bubbles obstructing side channels (curved arrows). By Prof J Venkat Professor in Radiography Chennai India
- 25. ARTEFACTS Reflux • Craniocaudal ductogramshows the cannula within a papilloma (arrow). • Note the reflux of contrast material to the surface. By Prof J Venkat Professor in Radiography Chennai India
- 26. POST PROCEDURAL CARE •Remove the cannula catheter • The dilation of the duct can sometimes be uncomfortable; however it is usually not painful. The nipple may be squeezed to remove the contrast. • Pain killers may be given By Prof J Venkat Professor in Radiography Chennai India
- 27. THANK YOU • References •Radiological Procedures - A Guideline Edited by Dr Bhushan N. Lakhakar • A Guide to Radiological Procedures Edited by Stephen Chapman • Fundamentals of Special Radiographic Procedures Edited by ALBERT M. SNOPEK • Clark’s Positioning in Radiography By Kathleen C Clark (1896-1968) • Techniques in Diagnostic Imaging Edited by Graham H. White House and Brian s. Worthington • Wikipedia, The Free Encyclopedia • Ductography: How To and What If S. Horatio Slawson, MD • Bradley A. Johnson, MD By Prof J Venkat Professor in Radiography Chennai India +919444923675 WhatsApp venkatdgr8@gmail.com