Pfeiffer K H, Wiest D, Hirnle P
Universitäts-Frauenklinik Tübingen.
Ultraschall Med. 1990 Aug;11(4):172-5. doi: 10.1055/s-2007-1011555.
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).
210名患者被纳入一项前瞻性研究，以比较盆腔超声检查和双合诊妇科触诊各自的优势。这两种方法得出的诊断结果在每种情况下均通过剖腹手术在解剖部位得到证实，并且也经过了组织学证实。每种检查由两个不同团队中的一个独立进行，以排除对诊断的任何相互影响。在这些条件下，超声检查中有158例（75.2%），妇科触诊中有144例（68.6%）得出了正确诊断。这种差异不显著。然而，这些数据因病理结果而异。在165名患者中，超声检查诊断出子宫病变。这一结果仅略优于妇科检查。超声检查仅在确定子宫长度方面明显更准确（p小于0.01）。然而，超声检查在盆腔肿瘤，尤其是卵巢肿瘤的诊断方面明显更具优势。在该区域45例经证实有肿瘤生长的患者中，超声诊断在34例（75.6%）中被证明是正确的，而触诊仅在22例（48.9%）中正确。这种差异非常显著（p小于0.005）。更确切地说，在以下方面发现有利于超声检查的显著差异：器官识别（p小于0.001）、器官分界（p小于0.002）、内部结构确定（p小于0.002）、体积测量（p小于0.01），以及——最重要的——肿瘤类型指示（p小于0.01）。
