[Value of sonography in diagnosis of uncertain lesions of the abdominal wall and inguinal region]

Abstract

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.