Helin H L, Penttinen J, Kirkinen P
Department of Obstetrics and Gynaecology, University Hospital of Kuopio, Finland.
Br J Obstet Gynaecol. 1999 May;106(5):410-4. doi: 10.1111/j.1471-0528.1999.tb08292.x.
To examine the accuracy of perioperative ultrasonography in detecting pelvic and para-aortic lymph nodes, and to compare the ultrasonographic findings with those observed in histology.
Forty women with gynaecological malignancy were examined by ultrasonography during their operations before surgical exploration of the lymph nodes; 182 specimens were taken for histological analysis.
Ultrasonographic findings were compared with histological diagnoses of lymph node biopsies.
Suspicious lymph nodes (diameter > 5 mm) were found in 31 lymph node regions. Seventeen histologically malignant lymph nodes were found. The sensitivity, specificity, and accuracy of finding metastatic lymph nodes by ultrasonography were 71%, 88%, and 87%, respectively. The frequency of false negative ultrasonographic findings was 29%.
Perioperative ultrasonographic examination can be of use in localising pelvic and paraaortic lymph nodes, especially in laparoscopic operations, where tactile palpation of the retroperitoneal space is not possible. The negative predictive value of the method is high, but the relatively poor sensitivity limits its diagnostic value.
探讨围手术期超声检查在检测盆腔及腹主动脉旁淋巴结方面的准确性，并将超声检查结果与组织学观察结果进行比较。
40例患有妇科恶性肿瘤的女性在手术过程中、淋巴结手术探查前接受了超声检查；共采集了182个标本进行组织学分析。
将超声检查结果与淋巴结活检的组织学诊断进行比较。
在31个淋巴结区域发现可疑淋巴结（直径>5mm）。组织学检查发现17个恶性淋巴结。超声检查发现转移性淋巴结的敏感性、特异性和准确性分别为71%、88%和87%。超声检查假阴性结果的发生率为29%。
围手术期超声检查可用于定位盆腔及腹主动脉旁淋巴结，尤其是在腹腔镜手术中，此时无法对腹膜后间隙进行触诊。该方法的阴性预测值较高，但相对较差的敏感性限制了其诊断价值。
