Perioperative ultrasonography of lymph nodes in patients with gynaecological malignancy

Objective To examine the accuracy of perioperative ultrasonography in detec ting pelvic and para-aortic lymph nodes, and to compare the ultrasonographi c findings with these observed in histology. Participants Forty women with gynaecological malignancy were examined by ul trasonography during their operations before surgical exploration of the ly mph nodes; 182 specimens were taken for histological analysis. Main outcome measures Ultrasonographic findings were compared with histolog ical diagnoses of lymph node biopsies. Results Suspicious lymph nodes (diameter > 5 mm) were found in 31 lymph nod e regions. Seventeen histologically malignant lymph nodes were found. The s ensitivity, specificity, and accuracy of finding metastatic lymph nodes by ultrasonography were 71%, 88%, and 87%, respectively. The frequency of fals e negative ultrasonographic findings was 29%. Conclusions Perioperative ultrasonographic examination can be of use in loc alising pelvic and paraaortic lymph nodes, especially in laparoscopic opera tions, where tactile palpation of the retroperitoneal space is not possible . The negative predictive value of the method is high, but the relatively p oor sensitivity limits its diagnostic value.