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Perioperative ultrasonography of lymph nodes in patients with gynaecological malignancy
H L Helin1, J Penttinen, P Kirkinen
1Department of Obstetrics and Gynaecology, University Hospital of Kuopio, Finland.
Objective:
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.
Participants:
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.
Main Outcome Measures:
Ultrasonographic findings were compared with histological diagnoses of lymph node biopsies.
Results:
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%.
Conclusions:
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.