[Diagnostic progress in malignant melanomas by high-resolution real-time sonography].

High-resolution real-time sonography enables visualization of the morphology of the cutis and subcutaneous layers. Evaluation of 19 malignant melanomas showed that tumors of a thickness of more than 0.6 mm can be seen sonographically. Malignant melanomas are revealed as nodules with very sparse internal echoes and sharp delineation, situated in the upper cutis. Infiltration of the subcutis can be shown reliably. The sonographically measured values of maximal tumor thickness show a good correlation with those determined postoperatively by histometry (r = 0.95). Regional metastases of melanomas and recurrencies are also revealed as sharply limited lesions with very few internal echoes. They can readily be separated from benign regressive nodules. Out of 237 examinations, the 181 evaluated ones showed a sonography sensitivity of 95% and a specificity of 99%. Therefore, an earlier diagnosis of regional metastases and recurrencies, as well as more precise indication for second operations during melanoma tumor follow-up can be made, and, in future, the decision for primary regional lymphonodectomy may be influenced. High-resolution sonography is thus a diagnostic imaging method which helps to evaluate preoperatively both malignant melanomas and their regional lymphatic areas.