[The value of gynecologic ultrasonography in comparison with gynecologic palpation].

210 patients were included in a prospective study comparing the respective advantages of pelvic sonography and bimanual gynaecological palpation. The diagnoses resulting from these two methods were confirmed in each case at the anatomic situs by laparotomy and also histologically. Each kind of examination was conducted independently by one of two different teams to exclude any mutual influence on the diagnosis. Under these conditions, 158 (75.2%) of the sonographic examinations and 144 (68.6%) of the gynaecological palpations resulted in a correct diagnosis. This difference was not significant. However, these data varied depending on pathological findings. In 165 patients, uterus pathology was diagnosed sonographically. This result was only slightly better than that of the gynaecological examinations. Sonography was significantly more accurate (p less than 0.01) only in determining the uterus length. However, sonography was clearly superior in the diagnosis of pelvic, in particular ovarian, tumours. In 45 patients with proven tumorous growth in this area, the sonographic diagnosis proved correct in 34 cases (75.6%), palpation however only in 22 cases (48.9%). This difference was highly significant (p less than 0.005). More precisely, significant differences were found in favor of sonography in: organ identification (p less than 0.001), organ demarcation (p less than 0.002), determination of internal structure (p less than 0.002), volume measurement (p less than 0.01), and--most important--indication of tumour type (p less than 0.01).