The use of ultrasound in the diagnosis of pelvic pathology.

At the Universitäts-Frauenklinik Köln (Cologne) 515 patients with gynecological symptoms underwent 597 clinical and ultrasound examinations; 224 patients had a subsequent laparotomy which offered means of checking the clinical and ultrasound findings. There was full agreement between ultrasound and clinical examination in 80%, partial agreement in 9%, and no agreement in 11%. Ultrasound provided information not gained by clinical means in 12%. In those patients subjected to operation clinical examination provided correct and complete diagnoses in 70% of patients, partially correct diagnoses in 19%, and wrong diagnoses in 11%. Ultrasound, however, provided correct diagnoses in 78%, partially correct diagnoses in 14%, and wrong diagnoses in only 8%. The results of ultrasound and clinical findings tallied in 51%, in 38% the ultrasonogram provided more precise information than palpation, and in 11% the clinical findings were more revealing than ultrasound examination. Additional valuable information was provided by 13% of ultrasonograms. Ultrasonography was not a precise predictor of malignancy.