Truong S, Pfingsten F P, Dreuw B, Schumpelick V
Chirurgische Klinik, RWTH Aachen.
Chirurg. 1993 Jun;64(6):468-75.
In a prospective trial we investigated the value of ultrasound in 134 patients with clinical doubtful findings of the abdominal wall and inguinal region. Ultrasound diagnosis was made by predefined criteria. In 105 patients a definite diagnosis was made by means of operative findings, CT, NMR, or puncture. In 40 patients a hernia was found. The sensitivity of ultrasound was 85%, the specifity 93.8%, the positive predictive value as 89.5% and the negative predictive value was 91%. Separating the findings to localisation of the hernia results in highest sensitivity for epigastric hernia (100%) and lowest for crural hernia (72.7%). The specifity for all hernias was more than 96%. Liquid tumors (hematom, serom, abscess) could be differentiated from solid tumors (lymphom, metastatic nodule, lipom). The most frequent course of wrong diagnosis was mixing the different liquid or solid tumors among themselves because of similar sonomorphologic properties. The sensitivity for hematom, serom, abscess, lymphom and metastatic nodule was 87.5%, 100%, 66.6%, 77% and 85.7% respectively. The corresponding specifity was 97.8%, 97.8%, 100%, 96.7% and 98%. Ultrasound was found to be of value for the diagnosis of clinical indeterminal findings of the abdominal wall and inguinal region.
在一项前瞻性试验中，我们研究了超声对134例腹壁和腹股沟区临床检查结果存疑患者的诊断价值。超声诊断依据预先设定的标准进行。105例患者通过手术所见、CT、核磁共振成像（NMR）或穿刺获得了明确诊断。40例患者发现患有疝气。超声检查的敏感度为85%，特异度为93.8%，阳性预测值为89.5%，阴性预测值为91%。根据疝气的位置对检查结果进行分类，发现脐疝的敏感度最高（100%），股疝的敏感度最低（72.7%）。所有疝气的特异度均超过96%。液性肿瘤（血肿、血清肿、脓肿）可与实性肿瘤（淋巴瘤、转移结节、脂肪瘤）相鉴别。最常见的误诊情况是由于超声形态学特征相似，将不同的液性或实性肿瘤相互混淆。血肿、血清肿、脓肿、淋巴瘤和转移结节的敏感度分别为87.5%、100%、66.6%、77%和85.7%。相应的特异度分别为97.8%、97.8%、100%、96.7%和98%。研究发现，超声对于诊断腹壁和腹股沟区临床检查结果不明确的情况具有重要价值。
