B-mode ultrasonography was performed in 246 patients with suspected abdominal masses over a seven-year period. In 105 (43%), the accuracy of ultrasonic diagnosis was evaluated surgically. Sonography was proven correct in 60 (57%) patients who had undergone operation. Among 141 patients who had not undergone operation and whose diagnoses were established by other means, ultrasonography agreed with the clinical diagnosis in 69 (31%).
Ultrasound accuracy, as confirmed by operation, was highest for splenic masses (100%) and for aortic aneurysm (88%). Liver masses were correctly identified in 56% of patients and gallbladder lesions in 38%. While only a 48% accuracy was obtained in diagnosing pancreatic disease, 64% of all pseudocysts were localized. Ultrasonography correlated positively with operative findings in 56% of renal masses. Intraperitoneal abscess was accurately diagnosed in 61% of patients but retroperitoneal adenopathy in only 33%.
Abdominal ultrasonography, while accurately diagnosing splenic and aortic masses, failed to identify approximately half of other mass lesions. Improved techniques hold promise of improving this diagnostic accuracy.