Kanker ovarium merupakan keganasan organ viseral dan paling mematikan serta dianggap silent killer. Kanker ini umumnya baru menimbulkan keluhan bila telah menyebar ke rongga peritoneum atau organ visera lainnya. Pada tingkat ini penyakit telah mencapai stadium lanjut sehingga tindakan pembedahan dan terapi adjuvan seringkali tidak menolong. Kurangnya gejala awal maupun sensitifitas skrining serta teknik deteksi dini merupakan alasan keterlambatan dalam diagnosis. Pengenalan dini kanker ovarium stadium awal berdasarkan pemeriksaan fisik saja tidak cukup sehingga perlu dilengkapi pemeriksaan radiologi seperti Ultrasonografi (USG), Computted Tomography Scan, Magnetic Resonance Imaging (MRI). USG Doppler adalah teknik pencitraan yang sering digunakan, noninvasif, biaya relatif murah, dan ditoleransi dengan baik. Penggunaan USG Doppler dimungkinkan untuk menilai vaskularisasi tumor dan nilai resistive index. Penelitian ini bertujuan mengetahui nilai diagnostik USG Doppler dalam menentukan keganasan tumor ovarium dibandingkan hasil histopatologi. Penelitian ini dilaksanakan di Bagian Radiologi RS. Dr. Wahidin Sudirohusodo dan RS. Universitas Hasanuddin, Makassar dimulai pada bulan Juni-Agustus 2018. Desain penelitian menggunakan uji diagnostik. Sebanyak 55 sampel dengan klinis tumor ovarium umur 14-67 tahun dilakukan pemeriksaan USG Doppler untuk menilai distribusi vaskuler, jumlah vaskuler, dan nilai resistive index, dilanjutkan sistem kategori untuk menentukan sifat tumor jinak atau ganas. Ganas, jika terdapat ≥ 2 kriteria Doppler ganas, dan jinak jika terdapat < 2 kriteria Doppler ganas. Hasil diagnosis USG Doppler dibandingkan dengan hasil histopatologi. Data dianalisis secara statistik berdasarkan uji diagnostik. Hasil penelitian menunjukkan USG Doppler memiliki nilai diagnostik yang cukup tinggi dalam menilai keganasan tumor ovarium dengan sensitivitas 94,7%, spesifisitas 70,6%, nilai prediksi posistif 87,8%, nilai prediksi negatif 85,7% dan akurasi 87,2%.
Ovarian cancer is a visceral organ malignancy that is lethal and is considered as “silent killer”. This cancer typically cause complaint if it has spread to peritoneum cavity or other visceral organ where the disease reached late stage, thus, surgical or adjuvant therapy is not beneficial anymore. The lack of early manifestation, screening sensitivity and difficulty in early detection technique are reasons for delay diagnosis. Early detection of ovarian cancer based on physical examination is not sufficient, and should be completed with imaging studies such as USG, CT scan, MRI and nuclear medicine. Doppler US is a technique that is non-invasive, relatively cheap and well-tolerated. This examination may assessed tumor vascularization and resistive index. This study aimed to investigate the diagnostic values of Doppler Ultrasound in determining the malignancy of ovarian tumor compared with result of histopathology. This study was conducted in Radiology Department of Dr.Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital, Makassar from June through August 2018. Design of the study was diagnostic test. Doppler Ultrasound examination was carried on 55 samples with clinical sign of ovarian tumor aged between 14-67 years to evaluate the vascular distribution, number of vascular, and values of resistive index; followed by categorical system to determine the characteristics of benign or malignant ovarian tumor. The lesion is considered malignant if two or more Doppler malignant criteria were found, and benign if less than two criteria were found. The result of Doppler was compared to the result of histopathology. Data were analyzed statistically based on diagnostic test. This study result showed that Doppler Ultrasound had diagnostic value which was high enough to evaluate tumor malignancy with sensitivity of 94.7%, specificity of 70.6%, positive predictive value of 87.8%, negative predictive value of 85.7%, and the accuracy of 87.2%.
Background: Thyroid nodules are still a health problem today. The incidence of thyroid nodules is still high. Thyroid nodules are found in 60% of the human population. Most thyroid nodules are benign, whereas malignant ones account for only about 10% of cases. Efforts are needed to determine the diagnostic value of ultrasound elastography and cytokeratin -19 biomarkers in determining the type of thyroid nodule. Methods: This study is a diagnostic test on 42 thyroid nodule patients. Elastography examination using GE Logic 7 expert ultrasound and cytokeratin 19 biomarker examination using cubital vein blood. Result: The study participant was dominated by 38 women and 4 men. The age range of the study subjects was dominated by the age range less than and up to 40 years with 27 people (64.3%) and at least in the age range more than 60 years with 3 people (7.1%). Elastography's receiver operator characteristics (ROC) curve in determining thyroid nodules found that Elastography's ability to diagnose benign and malignant thyroid nodules was good with an area under curve (AUC) of 0.8409 (84.09%). ROC curve of cytokeratin-19 gene m-RNA expression in determining thyroid nodules found that the ability of cytokeratin-19 gene m-RNA expression in diagnosing benign and malignant thyroid nodules is excellent with an area under curve (AUC) of 0.9795 (97.95%). Conclusion: Elastography has a good ability to determine the thyroid nodule while Cytokeratin-19 has an excellent ability to determine the type of thyroid nodule.
Limfadenopati dapat disebabkan oleh berbagai kondisi mulai dari keganasan, infeksi, autoimun, dan iatrogenik. Limfadenopati pada usia anak dan dewasa yang ukurannya tidak bertambah besar dalam kurun waktu kurang dari dua minggu atau lebih dari 12 bulan tidak bersifat neoplastik. Penelitian ini bertujuan mengetahui kesesuaian gambaran CT Scan leher dengan hasil biopsi aspirasi jarum halus (BAJAH) untuk membedakan limfadenopati leher yang jinak dan ganas. Penelitian ini dilaksanakan di Departemen Radiologi RS. Dr. Wahidin Sudirohusodo dan RS Universitas Hasanuddin Makassar mulai bulan Desember 2017 sampai Mei 2018. Sampel sebanyak 61 orang dengan rentang usia 4 - 82 tahun. Metode yang digunakan adalah observasional analitik dengan pendekatan cross sectional. Hasil penelitian menunjukkan gambaran keganasan limfadenopati leher pada CT Scan yang sesuai dengan BAJAH yaitu penyebaran ekstrakapsular, nekrosis sentral, bentuk bulat/lobulated dan margin irregular, sedangkan kalsifikasi dan ukuran tidak sesuai. Gambaran CT Scan limfadenopati leher yang jinak sesuai dengan hasil BAJAH yaitu tidak ada penyebaran ekstrakapsular, tidak ada nekrosis sentral, bentuk oval dan margin regular, sedangkan kalsifikasi dan ukuran tidak sesuai.
Lymphadenopathy can be caused by various conditions that were malignancy, infection, autoimmunity, and iatrogenic. In adults and children, lymphadenopathy whose duration is less than two weeks or more than 12 months but its size does not increase, that is not a neoplastic. The study aims to determine the relationship between CT Scan of neck image and the result of fine needle aspiration biopsy (FNAB) in distinguishing benign and malignant cervical lymphadenopathies. The research was conducted in Radiology Department of Dr. Wahidin Sudirohusodo and Universitas Hasanuddin Hospital Makassar from December to May 2018. The sample were 61 people aged form 4 – 82 years old. The observational analytic with cross sectional analytic were used in this study. The result revealed that image of malignant lymphadenopathies in CT Scan of neck were significantly related with FNAB results; extracapsular spread; central necrosis, lobulated or rounded forms with irregular margin, while calcification and size were not related. The image of benign lymphadenopathies in CT Scan of neck was related with FNAB results; no extracapsular spread, no central necrosis, oval formed with regular margin, while calcification and size were not related.
The study aims to determine the correlation between diameter of optic nerve sheath on grey scale with increased intracranial pressure in patients with intracranial lesion. The research was conducted in Radiology Department of Dr. Wahidin Sudirohusodo Makassar from January 2019 – May 2019. The sample were 39 people aged ³18 years old with intracranial lesion. Axial computed tomography (CT) examination was performed to evaluate intracranial lesions and the presence of midline shift. The diameter of the optic nerve sheath was measured using eye ultrasonography. Data analyses used Spearman’s correlation test. The results showed that there was a correlation between the dilatation of the right and left optic nerve sheath diameter with midline shift (p value 0.04; p less than 0.05) on the diameter of the right optic nerve sheath showing a weak positive relationship (p value 0.02) for the diameter the optic nerve sheath left showing a medium positive relationship where the higher the midline shift, the wider the diameter of the left and right optical nerve sheath. There is a correlation between the right and left optic nerve sheath diameter (p less than equal 0.001) showing a strong positive relationship where the wider the diameter of the right optic nerve sheath, the wider the diameter of the left optic nerve sheath at high intracranial pressure. Statistically other results also obtained no relationship between dilatation of the diameter of the optic nerve sheath with clinical symptoms of increased intracranial pressure and type of lesion.
Karsinoma nasofaring (KNF) adalah tumor yang berasal dari fossa rosenmuller pada nasofaring yang merupakan daerah transisional dimana epitel kuboid berubah menjadi epitel skuamosa serta merupakan tumor terbanyak di ASIA dan terutama negara berkembang seperti Indonesia. Penelitian ini dilakukan untuk mengetahui hubungan karakteristik penderita karsinoma nasofaring terhadap respon kemoterapi dengan menggunakan klasifikasi Response Evaluation Criteria In Solid Tumor 1.1 (RECIST) di RSUP Dr. Wahidin Sudirohusodo Makassar dengan jumlah sampel sebanyak 115 sampel yang masuk kriteria inklusi. Penilaian respon tumor didasarkan pemeriksaan CT Scan Nasofaring saat awal didiagnosa KNF dan setelah dilakukan kemoterapi 6 siklus, kemudian dinilai usia,ukuran massa tumor, kelenjar getah bening regional, dan stadium tumor pada lesi target yang didapatkan terhadap RECIST 1.1. Hasil penelitian ini menunjukkan usia, ukuran massa tumor, kelenjar getah bening regional , dan stadium tumor memiliki hubungan yang searah dengan RECIST 1.1 dimana semakin tua usia penderita, semakin banyak perluasan kelenjar getah bening regional, dan semakin tinggi kategori stadium tumor penderita karsinoma nasofaring maka hasil penilaian RECIST 1.1 cenderung semakin memburuk (Usia terhadap RECIST 1.1: Koefisien korelasi 0.277, P value 0.003; Ukuran massa tumor terhadap RECIST 1.1: Koefisien korelasi :0.625, P value : 0.001; Kelenjar Getah Bening Regional terhadap RECIST 1.1: Koefisien korelasi : 0.361, P value 0.001; Stadium tumor terhadap RECIST 1.1: Koefisien korelasi : 0.418, P value : 0.001) Kata kunci : RECIST 1.1, Usia, Ukuran Massa Tumor, Kelenjar Getah Bening Regional, Stadium Tumor, Histopatologi, CT-Scan
ABSTRACT
DWI with ADC mapping adds value to conventional MRI imaging by offering assessment of cellularity functionality with the potential to help differentiate between benign and malignant lesions. The aim of this study is to assess the accuracy of the ADC value MRI in predicting soft tissue tumors benign and malignant. This study was carried out by the Radiology Installation of Wahidin Sudirohusodo Hospital from February 2020 to August 2022 with a sample of 36 people and an age range of 9-74 years. The statistical method used was to calculate the value of sensitivity, specificity, Positive Predictive Value and Negative Predictive Value to assess accuracy as well as ROC and Mann Whitney tests. The results show that it consists of 36 samples with soft tissue tumors (malignant: 25 samples and benign : 11 samples). The mean value of ADC for malignant soft tissue tumors is 0.998 ± 0.526 x 10-3mm2/s and benign is 1.705 ± 0.665 x 10-3mm2/s. With a Cut Off value to distinguish malignant and benign soft tissue tumors of 1,265 x 10-3 mm2/s, with a sensitivity of 81.8%, specificity of 80%, Positive Predictive Value 64.3%, Negative Predictive Value 90.9%, Accuracy 80.5% and AUC 0.81. The accuracy of the ADC MRI value is 80.5%, indicating that the ADC value can be used as an additional modality to help predict benign and malignant soft tissue tumors.
Keywords: Soft tissue tumor, MRI, DWI, ADC, Histopathology
Hidronefrosis dapat terjadi pada satu atau kedua ginjal yang menyebabkan aliran urine menjadi lemah dan mengganggu fungsi dari ginjal itu sendiri.Penelitian ini bertujuan mengetahui korelasi ketebalan korteks ginjal dan resistive index ginjal berdasarkan pemeriksaan ultrasonografi pada pasien hidronefrosis. Penelitian ini dilakukan di bagian Radiologi Rumah Sakit Umum Pusat Dr. Wahidin Sudirohusodo Makassar dari Mei sampai dengan Agustus 2018. Desain penelitian yang digunakan adalah observasional dengan rancangan potong lintang.Sampel penelitian sebanyak empat puluh orang yang memiliki klinis hidronefrosis. Pemeriksaan ultrasonografi grayscale terhadap pasien dilakukan untuk mengukur ketebalan korteks ginjal yang dilakukan di bagian tengah ginjal pada potongan longitudinal dan diukur dari puncak piramid tegak lurus ke arah kapsul, kemudian dilanjutkan pemeriksaan ultrasonografi doppler di arteri interlobar atau arcuata pada pole superior, median, dan inferior ginjal untuk menilai renal resistiveindex. Data dianalisis dengan analisis statistik melalui uji korelasi Spearman dan Pearson.Hasil penelitian menunjukkan bahwa rerata sampel penelitian mengalami hidronefrosis derajat ringan. Mean tebal korteks ginjal kanan pada penelitian ini 0,9 cm (0,26-1,79cm) dan ginjal kiri 0,84 cm (0,22-1,57cm). Terdapat korelasi yang bermakna antara derajat hidronefrosis dengan ketebalan korteks ginjal kanan dan kiri dengan arah korelasi negatif (p=0,0001). Kecenderungan peningkatan derajat hidronefrosis, meningkatkan nilai resistive index meskipun secara statistik tidak bermakna. Tidak terdapat korelasi antara ketebalan korteks dan resistive index ginjal berdasarkan pemeriksaan ultrasonografi.
Hydronephrosis can occur in one or both kidneys which causes the flow of urine to become weak and interfere with the function of the kidney. This research aimed to investigate the correlation between the cortex thickness and the resistive index of kidney based on the ultrasonography examination in hydronephrosis patients. The research was conducted in Radiology Department of Dr. Wahidin Sudirohusodo General Hospital, Makassar from May through August 2018. The research design used was observational using the cross sectional design. The total samples comprised 40 samples with clinical hydronephrosis. The examination of ultrasonography grayscale was carried out in order to measure the cortex thickness of the kidneys in the central parts of kidneys and the longitudinal cut was measured from the pyramid top straight down the capsule, then it was continued with the Doppler ultrasonography examination in the interlobare artery or arcute at superior pole, median and inferior kidney in order to evaluate the renal resistive index. The data were analyzed using the statistical analysis through the correlation tests of Spearman and Pearson. The research results indicated that the mean research samples had experienced the light hydronephrosis. The mean cortex thickness of the right kidney was 0.9 cm (0.26 - 1.79 cm), and that of the left kidnet was 0.84 cm (0.22 - 1.57 cm). There was a significant correlation between the degree of hydronephrosis and the cortex thickness of the right and the left kidneys, with the direction of the negative correlation (p=0.0001). There was a tendency of the increase of hydronephrosis degree to increase the value of resistive index, though statistically it was insignificant. There was no correlation between the cortex thickness and the resistive index of kidney based on the ultrasonogrphy examination.
Sistitis interstitial memiliki patogenesis yang kompleks dan berhubungan dengan penggunaan obat statin dengan mekanisme yang belum diketahui secara pasti. Penelitian ini bertujuan untuk menyelidiki efek simvastatin pada jaringan makroskopis urin dan kandung kemih setelah pengobatan simvastatin pada model tikus sistitis interstitial akut yang diinduksi protamin sulfat. Dua belas tikus Wistar betina dewasa dimasukkan. Mereka dibagi menjadi tiga kelompok (masing-masing n=4), yaitu kelompok plasebo+protamin sulfat (KP), kelompok simvastatin 10 mg/kgBB + protamin sulfat (S10P), dan kelompok simvastatin 50 mg/kgBB + protamin sulfat (S50P). Semua hewan diobati baik dengan plasebo CMC 0,5% atau simvastatin dengan gavage oral selama 30 hari diikuti dengan instilasi protamine sulfate (10 mg/ml) intraveska. Semua hewan diterminasi untuk sampel urin dan jaringan kandung kemih tiga hari setelah induksi. Derajat hematuria pada kedua kelompok simvastatin secara signifikan lebih tinggi daripada kelompok kontrol (p = 0,03). Hanya berat kandung kemih relatif pada kelompok S50P yang secara signifikan lebih tinggi daripada kelompok kontrol (p=0,032). Derajat edema dan hemoragik makroskopis buli-buli pada kedua kelompok simvastatin tidak berbeda signifikan dengan kelompok kontrol. Sebagai kesimpulan, simvastatin dapat berkontribusi pada kronisitas sistitis interstitial akut melalui modulasi hipervaskularisasi jaringan dan keadaan hipertrofi.
Kanker ovarium merupakan keganasan organ viseral dan paling mematikan serta dianggap silent killer. Kanker ini umumnya baru menimbulkan keluhan bila telah menyebar ke rongga peritoneum atau organ visera lainnya. Pada tingkat ini penyakit telah mencapai stadium lanjut sehingga tindakan pembedahan dan terapi adjuvan seringkali tidak menolong. Kurangnya gejala awal maupun sensitifitas skrining serta teknik deteksi dini merupakan alasan keterlambatan dalam diagnosis. Pengenalan dini kanker ovarium stadium awal berdasarkan pemeriksaan fisik saja tidak cukup sehingga perlu dilengkapi pemeriksaan radiologi seperti Ultrasonografi (USG), Computted Tomography Scan, Magnetic Resonance Imaging (MRI). USG Doppler adalah teknik pencitraan yang sering digunakan, noninvasif, biaya relatif murah, dan ditoleransi dengan baik. Penggunaan USG Doppler dimungkinkan untuk menilai vaskularisasi tumor dan nilai resistive index. Penelitian ini bertujuan mengetahui nilai diagnostik USG Doppler dalam menentukan keganasan tumor ovarium dibandingkan hasil histopatologi. Penelitian ini dilaksanakan di Bagian Radiologi RS. Dr. Wahidin Sudirohusodo dan RS. Universitas Hasanuddin, Makassar dimulai pada bulan Juni-Agustus 2018. Desain penelitian menggunakan uji diagnostik. Sebanyak 55 sampel dengan klinis tumor ovarium umur 14-67 tahun dilakukan pemeriksaan USG Doppler untuk menilai distribusi vaskuler, jumlah vaskuler, dan nilai resistive index, dilanjutkan sistem kategori untuk menentukan sifat tumor jinak atau ganas. Ganas, jika terdapat ≥ 2 kriteria Doppler ganas, dan jinak jika terdapat < 2 kriteria Doppler ganas. Hasil diagnosis USG Doppler dibandingkan dengan hasil histopatologi. Data dianalisis secara statistik berdasarkan uji diagnostik. Hasil penelitian menunjukkan USG Doppler memiliki nilai diagnostik yang cukup tinggi dalam menilai keganasan tumor ovarium dengan sensitivitas 94,7%, spesifisitas 70,6%, nilai prediksi posistif 87,8%, nilai prediksi negatif 85,7% dan akurasi 87,2%.
Ovarian cancer is a visceral organ malignancy that is lethal and is considered as “silent killer”. This cancer typically cause complaint if it has spread to peritoneum cavity or other visceral organ where the disease reached late stage, thus, surgical or adjuvant therapy is not beneficial anymore. The lack of early manifestation, screening sensitivity and difficulty in early detection technique are reasons for delay diagnosis. Early detection of ovarian cancer based on physical examination is not sufficient, and should be completed with imaging studies such as USG, CT scan, MRI and nuclear medicine. Doppler US is a technique that is non-invasive, relatively cheap and well-tolerated. This examination may assessed tumor vascularization and resistive index. This study aimed to investigate the diagnostic values of Doppler Ultrasound in determining the malignancy of ovarian tumor compared with result of histopathology. This study was conducted in Radiology Department of Dr.Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital, Makassar from June through August 2018. Design of the study was diagnostic test. Doppler Ultrasound examination was carried on 55 samples with clinical sign of ovarian tumor aged between 14-67 years to evaluate the vascular distribution, number of vascular, and values of resistive index; followed by categorical system to determine the characteristics of benign or malignant ovarian tumor. The lesion is considered malignant if two or more Doppler malignant criteria were found, and benign if less than two criteria were found. The result of Doppler was compared to the result of histopathology. Data were analyzed statistically based on diagnostic test. This study result showed that Doppler Ultrasound had diagnostic value which was high enough to evaluate tumor malignancy with sensitivity of 94.7%, specificity of 70.6%, positive predictive value of 87.8%, negative predictive value of 85.7%, and the accuracy of 87.2%.
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