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"[ABSTRAKTujuan: Studi ini merupakan studi MRI (Magnetic Resonance Imaging) untuk menilai hubungan asimetrisitas volume, hiperintensitas T2WI FLAIR dan nilai ADC hippokampus hubungannya dengan lateralisasi kejang. Pemeriksaan MRI sekuens rutin ditambah prosedur khusus pemeriksaan hipokampus yaitu sekuens T2WI Inversion Recovery dan T2WI Fluid-attenuated inversion recovery (FLAIR) dapat menilai volume hipokampus. Sekuens DWI (Diffusion Weighted Image) dan ADC (Appearent Difusion Coeffesient) merupakan pemeriksaan kuantitatif.Metode: Penelitian potong lintang menggunakan data sekunder MRI kepala pasien dengan diagnosis epilepsi lobus temporal mesial. Dilakukan pengukuran volume pada potongan koronal sejajar sumbu hippokampus, mulai dari terlihat kepala hippokampus sebanyak 5 irisan. Melihat gambaran hiperintensitas T2WI FLAIR serta mengukur nilai ADC hippokampus dilakukan dengan meletakan ROI pada potongan aksial hippokampus terbesar pada ADC map. Analisis data dilakukan untuk menghitung nilai R Kappa hubungan masing masing variabel dan gabungan variabel.Hasil: Jumlah subyek penelitian 54 orang, terdapat hubungan asosiasi yang cukup kuat (sedang) dan ipsilateral antara hiperintensitas T2WI FLAIR dan asimetrisitas volume dengan lateralisasi kejang dengan R Kappa sama sebesar + 0.52. Hubungan asosiasi yang lemah dan bersifat ipsi lateral dengan R Kappa + 0.37 antara nilai ADC dengan lateralisasi kejang. Hubungan asosiasi antara asimetrisitas volume dan asimetrisitas nilai ADC adalah kontralateral dengan hubungan asosiasi cukup kuat (sedang). Penentuan lateralisasi lesi dengan MRI pada masing masing variabel memiliki sensitivitas dan spesifisitas cukup tinggi. Hubungan asosiasi gabungan 2 dan 3 variabel adalah cukup kuat (sedang) dan bersifat ipsilateral, dengan nilai R Kappa, sensitifitas dan spesifisitanya yang lebih tinggi dibandingkan dengan hubungan masing masing variabel.Kesimpulan: MRI memiliki peranan penting menentukan lateralisasi kejang. Menilai hubungan dari gabungan 2 dan 3 variabel didapatkan secara statistik lebih besar hubungannya dengan lateralisasi kejang dibandingkan dengan menghubungkan masing masing variabel secara terpisah, sehingga penilaian MRI yang dilakukan untuk ke 3 variabel ini akan lebih menguatkan diagnosis sisi hipokampus yang mengalami kelainan.

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ABSTRACTObjective: This study is MRI ( Magnetic Resonance Imaging ) to assess the relationship asymmetry volume, T2WI FLAIR hyperintensity and hippocampal ADC values its relationship with the lateralization of seizures. Routine MRI examination sequences plus a special procedure that hippocampal examination Inversion Recovery sequence T2WI and T2WI Fluid-attenuated inversion recovery ( FLAIR ) can assess hippocampal volume. Sequences DWI ( Diffusion Weighted Image ) and ADC ( Appearent Diffusion Coeffesient ) is a quantitative examination.Methods: A cross-sectional study using secondary data MRI diagnosis of the patient's head with mesial temporal lobe epilepsy. Volume measurements performed on coronal slice axis parallel to the hippocampus, ranging from the visible head of the hippocampus as much as 5 slices. See picture T2WI FLAIR hyperintensity and measuring the ADC value hippocampus done by placing the ROI on axial cuts at the largest hippocampal ADC map. Data analysis was performed to calculate the value of R Kappa relationship each and combined variable.Results: There is a fairly strong association relationship (medium) and ipsilateral between T2WI FLAIR hyperintensity volume and asymmetry with lateralization of seizures with R Kappa equal to + 0.52. A weak association relationship and are IPSI lateral with R Kappa + 0.37 between the ADC values with lateralization of seizures. Association relationship between volume and asymmetry value asymmetry ADC is contralateral to the association relationship is strong enough (medium). Determination of lateralization of lesions by MRI in each variable has a fairly high sensitivity and specificity. The combined association relationship 2 and 3 variables are strong enough (medium) and ipsilateral, with a value of R Kappa, sensitivity and spesifisitanya higher than the correlation of each variable.Conclusion: MRI has an important role determining the lateralization of seizures. Assess the relationship of the combined second and third variables are statistically bigger obtained conjunction with lateralization of seizures compared to connecting each variable separately, so the MRI assessment carried out for 3 to this variable will further strengthen the diagnosis of hippocampal abnormalities., Objective: This study is MRI ( Magnetic Resonance Imaging ) to assess the relationship asymmetry volume, T2WI FLAIR hyperintensity and hippocampal ADC values its relationship with the lateralization of seizures. Routine MRI examination sequences plus a special procedure that hippocampal examination Inversion Recovery sequence T2WI and T2WI Fluid-attenuated inversion recovery ( FLAIR ) can assess hippocampal volume. Sequences DWI ( Diffusion Weighted Image ) and ADC ( Appearent Diffusion Coeffesient ) is a quantitative examination.Methods: A cross-sectional study using secondary data MRI diagnosis of the patient's head with mesial temporal lobe epilepsy. Volume measurements performed on coronal slice axis parallel to the hippocampus, ranging from the visible head of the hippocampus as much as 5 slices. See picture T2WI FLAIR hyperintensity and measuring the ADC value hippocampus done by placing the ROI on axial cuts at the largest hippocampal ADC map. Data analysis was performed to calculate the value of R Kappa relationship each and combined variable.Results: There is a fairly strong association relationship (medium) and ipsilateral between T2WI FLAIR hyperintensity volume and asymmetry with lateralization of seizures with R Kappa equal to + 0.52. A weak association relationship and are IPSI lateral with R Kappa + 0.37 between the ADC values with lateralization of seizures. Association relationship between volume and asymmetry value asymmetry ADC is contralateral to the association relationship is strong enough (medium). Determination of lateralization of lesions by MRI in each variable has a fairly high sensitivity and specificity. The combined association relationship 2 and 3 variables are strong enough (medium) and ipsilateral, with a value of R Kappa, sensitivity and spesifisitanya higher than the correlation of each variable.Conclusion: MRI has an important role determining the lateralization of seizures. Assess the relationship of the combined second and third variables are statistically bigger obtained conjunction with lateralization of seizures compared to connecting each variable separately, so the MRI assessment carried out for 3 to this variable will further strengthen the diagnosis of hippocampal abnormalities.]"

"[ABSTRAKLatar belakang: Penggunaan media kontras pada pemeriksaan radiologi dengan kondisi pasien mengalami insufisiensi fungsi ginjal dapat menyebabkan resiko terjadinya CIN pada kontras iodine dan NSF pada kontras paramagnetik. Oleh karena itu, penilaian fungsi ginjal penting dilakukan sebelum pemeriksaan radiologi kontras. Permasalahannya untuk menilai fungsi ginjal dengan baku emas sulit dilakukan sehingga digunakan formula MDRD dan CKD-EPI untuk menghitung eGFR. Faktor ras menjadi salah satu variabel dalam formula penghitungan eGFR, belum ada untuk populasi Indonesia yang termasuk ras Melanesia dan Malayan-Mongoloid. Tujuan: Menilai apakah terdapat korelasi antara pengukuran eGFR metode MDRD dan CKD-EPI dengan pengukuran GFR 99mTc-DTPA metode Gates pada pasien CKD. Metode: Penelitian potong lintang menggunakan data sekunder pasien yang menjalani pemeriksaan skintigrafi renal di RSUPN Cipto Mangunkusumo serta pemeriksaan kreatinin serum bulan Februari 2012-Januari 2015. Data kasar dinilai ulang GFR skintigrafi renal menggunakan metode Gates dari pesawat Siemens Symbia T2 dan dihitung nilai eGFR menggunakan formula MDRD dan CKD-EPI. Analisa data dilakukan untuk mendapatkan nilai korelasi eGFR formula MDRD dan CKD-EPI dengan GFR skintigrafi renal sebagai baku emas. Hasil: Jumlah subjek penelitian 47 orang, dengan hasil terdapat korelasi positif, kekuatan korelasi baik antara nilai eGFR MDRD dengan GFR skintigrafi renal dengan persamaan:nilai GFR skintigrafi renal=16,60+0,70xnilai eGFR MDRD. Terdapat korelasi positif, kekuatan korelasi baik antara nilai eGFR CKD-EPI dengan GFR skintigrafi renal dengan persamaan:nilai GFR skintigrafi renal=12,74+0,78xnilai eGFR CKD-EPI; nilai GFR dalam ml/menit/1,73m2. Kesimpulan : Formula persamaan eGFR MDRD dan CKD-EPI dapat digunakan dalam klinis untuk memperkirakan nilai GFR skintigrafi renal.

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ABSTRACTBackground: The use of contrast media for radiology examination in patients with renal function insufficiency can lead to the risk of CIN (Contrast Induced Nephropathy) on contrast iodine and NSF (Nephrogenic Systemic Fibrosis) on paramagnetic contrast. Therefore, assessment of renal function is important to be done prior to contrast radiology. The problem is assessing renal function with a gold standard, clinically difficult, therefor using MDRD and CKD-EPI formula to calculate eGFR. Factors race became one of the variables in the formula calculating eGFR, yet for Indonesian population included in the Melanesian and Malayan-Mongoloid race.Objective. To evaluate correlation value between eGFR measurement using MDRD and CKD-EPI methods with GFR Gates methods using 99mTc-DTPA in patients with CKD.Method: Cross sectional research using secondary data of patients who underwent renal scintigraphy in Cipto Mangunkusumo and serum creatinine examination in February 2012 to January 2015. The raw data then reassessed GFR renal scintigraphy using the Gates of Siemens Symbia T2 machine and eGFR values calculated using the formula MDRD and CKD-EPI. Data analysis was used to obtain a correlation value formula MDRD eGFR and CKD-EPI with GFR renal scintigraphy as the gold standard. Result: Total subject is 47 people. There is a positive correlation with good correlation value between MDRD eGFR value and renal scintigraphy GFR using this approach:renal scintigraphy GFR value=16,60+0,70xMDRD eGFR value. There is also a positive correlation with good correlation value between MDRD eGFR value and renal scintigraphy GFR value using this approach:renal scintigraphy GFR value=12,74+0,78xCKD=EPI eGFR value. Conclusion : Formula equation MDRD and CKD-EPI eGFR can be used clinically to estimate renal scintigraphy GFR, Background: The use of contrast media for radiology examination in patients with renal function insufficiency can lead to the risk of CIN (Contrast Induced Nephropathy) on contrast iodine and NSF (Nephrogenic Systemic Fibrosis) on paramagnetic contrast. Therefore, assessment of renal function is important to be done prior to contrast radiology. The problem is assessing renal function with a gold standard, clinically difficult, therefor using MDRD and CKD-EPI formula to calculate eGFR. Factors race became one of the variables in the formula calculating eGFR, yet for Indonesian population included in the Melanesian and Malayan-Mongoloid race.Objective. To evaluate correlation value between eGFR measurement using MDRD and CKD-EPI methods with GFR Gates methods using 99mTc-DTPA in patients with CKD.Method: Cross sectional research using secondary data of patients who underwent renal scintigraphy in Cipto Mangunkusumo and serum creatinine examination in February 2012 to January 2015. The raw data then reassessed GFR renal scintigraphy using the Gates of Siemens Symbia T2 machine and eGFR values calculated using the formula MDRD and CKD-EPI. Data analysis was used to obtain a correlation value formula MDRD eGFR and CKD-EPI with GFR renal scintigraphy as the gold standard. Result: Total subject is 47 people. There is a positive correlation with good correlation value between MDRD eGFR value and renal scintigraphy GFR using this approach:renal scintigraphy GFR value=16,60+0,70xMDRD eGFR value. There is also a positive correlation with good correlation value between MDRD eGFR value and renal scintigraphy GFR value using this approach:renal scintigraphy GFR value=12,74+0,78xCKD=EPI eGFR value. Conclusion : Formula equation MDRD and CKD-EPI eGFR can be used clinically to estimate renal scintigraphy GFR]"

"ABSTRAKLatar belakang dan tujuan : Trigeminal neuralgia (TGN) atau tic douloureux adalah rasa nyeri seperti ditusuk-tusuk pada satu sisi wajah. Prevalensi TGN 0,01% sampai 0,3%, angka kejadian 3,4 sampai 5,9 per 100.000 orang pertahun. 3D CISS MRI waktu akuisisi singkat, Signal to Noise Ratio tinggi, dan Contrast to Noise Ratio yang baik. Instrumen Pain Assessment Scale (PAS) yang digunakan adalah Pain Rating Scale (PRS) karena mudah digunakan, tersedia luas dan murah. PRS dapat dipertimbangkan sebagai instrumen penilaian perkiraan jarak Neurovascular compression terhadap Root Exit Zone (REZ).Metode : Penelitian retrospektif pada 32 subjek Trigeminal Neuralgia yang melakukan pemeriksaan 3D CISS MRI dalam rentang Januari 2013 sampai Januari 2016. Evaluasi 3D CISS MRI 32 subjek ditemukan 35 origin vaskular penyebab kompresi. Metode penelitian menggunakan uji korelatif dengan pendekatan potong lintang antara nilai PRS dengan jarak NC terhadap REZ yang dievaluasi menggunakan 3D CISS MRI.Hasil : Menggunakan tes Spearman terhadap 35 subjek kompresi diperoleh hasil terdapat korelasi antara nilai PRS dengan jarak NC terhadap REZ dengan rerata jarak kompresi 2,10 mm ± 2,10 (r = -0,39 dan p= 0,021). Dihasilkan formulasi regresi jarak kompresi 3,15 ? 0,47 x Skala nyeri.Kesimpulan : Terdapat korelasi antara nilai PRS dengan jarak NCterhadap REZ pada pasien Trigeminal neuralgia.

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ABSTRACTBackground and Objective: Trigeminal neuralgia or tic douloureuxis unilateral facial pain. TGN prevalence 0,01% to 0,3%, incidence rate 3,4 to 5,9 per 100.000 people a year. High signal to noise ratio and better contrast to noise ratio is 3D CISS MR benefits. Trigeminal pain evaluated with pain assessment scale because simple, less expensive and widely available. So it can be considered as an assessment instrument to estimates neurovascular compressiondistance related to trigeminal nerve root exit zone.Methods : This is a retrospective study on 32 subjects trigeminal neuralgia who had 3D CISS MR examination within January 2013 to January 2016. Evaluation 3D CISS MR found 35 vascular origin causes compression. This methods using correlative study with cross sectional between PAS value with neurovascular compression distance related to trigeminal nerve root exit zone.Results : From 35 subject compression with Spearman test there is moderate correlation between PAS value with neurovascular compression distance related to trigeminal nerve root exit zone (Mean 2.10 mm ± 2,10, r = -0,39 and p = 0,021) and result Regretion formulation 3,15 ? 0,47 x Pain scale.Conclusion : There is moderate correlation between PRS value with neurovascular compression distance related to trigeminal nerve root exit zone."

"Latar Belakang: Sklerosis multipel (multiple sclerosis/MS) merupakan penyakit inflamasi-demyelinasi sistem saraf pusat yang mengakibatkan atrofi struktur otak penderita. Indeks korpus kalosum (IKK) merupakan salah satu metode pengukuran morfometrik korpus kalosum yang cepat serta dengan reliabilitas interrater yang tinggi. Tujuan: Mengetahui korelasi antara hasil pengukuran IKK dengan volume korpus kalosum, substansi grisea kortikal, substansi grisea subkortikal, dan substansi alba serebri melalui MRI volumetri otak pada penderita MS. Metode : Hasil MRI kepala dari 30 penderita MS dilakukan pengukuran IKK. Nilai IKK kemudian dilakukan analisis korelasional dengan volume korpus kalosum, substansi grisea kortikal, substansi grisea subkortikal, dan substansi alba serebri yang diperoleh menggunakan perangkat lunak FreeSurfer©. Hasil : Terdapat korelasi yang sangat kuat antara IKK dengan volume korpus kalosum (R = 0,797 ; p = 0,001) dan volume substansi alba serebri (R = 0,813 ; p = 0,001). IKK juga berkorelasi kuat dengan volume substansi grisea kortikal (R = 0,642 ; p = 0,001) dan volume substansi grisea subkortikal (R = 0,696 ; p = 0,001). Kesimpulan : Metode pengukuran IKK dapat menjadi parameter morfometrik cepat dan sederhana yang menggambarkan volume korpus kalosum, substansi grisea kortikal, substansi grisea subkortikal, dan substansi alba serebri pada penderita MS.

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Background: Multiple sclerosis (MS) is an inflammatory-demyelinating disease of the central nervous system which results in atrophy of brain structure. Corpus callosum index (CCI) is a method of morphometric measurement of the corpus callosum using midsagittal slice from MRI which does not require additional sequences with fast processing time and high interrater reliability.

Objectives : To determine the correlation between the CCI measurements with corpus callosum, cortical gray matter, subcortical gray matter, and cerebral white matter volume through brain MRI volumetry in MS patients.

Methods : CCI measurements were obtained from head MRI from 30 MS patients according to the method conceived by Figueroa et al. Correlational analysis was carried out between CCI with corpus callosum, cortical gray matter, subcortical gray matter, and cerebral white matter volume obtained using FreeSurfer©.

Results : Very strong correlation was shown between CCI and corpus callosum volume (R = 0.797; p = 0.001) and cerebral white matter volume (R = 0.813; p = 0.001). CCI also shown strong correlation with cortical gray matter volume (R = 0.642; p = 0.001) and subcortical gray matter volume (R = 0.696; p = 0.001).

Conclusion : CCI can be a fast and simple morphometric parameter that describes the corpus callosum, cortical gray matter, subcortical gray matter, and cerebral white matter volume in MS patients."

"Latar belakang: Penyakit ginjal kronik sendiri dapat menjadi faktor risiko penyakit serebrovaskular karena ginjal dan parenkim otak memiliki kemiripan pembuluh distal (pada nefron dan arteriole di otak). Pembuktian korelasi antara penyakit ginjal kronik terhadap CSVD dapat dilakukan melalui evaluasi penurunan nilai laju filtrasi glomerulus (LFG) dan evaluasi temuan MRI kepala.Metode: Studi ini merupakan studi korelasi potong lintang dengan evaluasi MRI kepala dan penilaian sesuai acuan STRIVE, kemudian ditentukan korelasi terhadap rerata nilai estimasi laju filtrasi glomerulus penderita.Hasil: Terdapat korelasi negatif antara penyakit ginjal kronik terhadap CSVD (r = - 0,39 dan p = 0,029). Nilai median total skor CSVD adalah 2,5 dengan rerata nilai estimasi LFG pada penelitian ini 40 ml/menit per 1,73 m2.Kesimpulan: Terdapat korelasi negatif antara penyakit ginjal kronik terhadap CSVD. Diperlukan penelitian lanjutan dengan jumlah sampel lebih besar untuk menentukan nilai estimasi LFG yang menjadi cut-off point bagi pasien untuk menjalani MRI kepala, serta untuk mengetahui kaitan total skor CSVD dengan faktor risiko lainnya.

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Background: Cerebral Small Vessel Disease (CSVD) and chronic kidney disease (CKD) have similar and overlapping risk factors. CKD itself can be a risk factor for cerebrovascular diseases because of the similarities between small vessels in the brain and kidneys (nephrons). Correlation between CKD and CSVD can be proven by evaluating estimated GFR values and head MRI quantitatively.

Method: This study was a cross sectional study to determine the correlation between mean estimated GFR values in CKD and quantitative head MRI evaluation of CSVD. Result: There was a weak negative correlation between mean estimated GFR values with CSVD. Median of total score CSVD from all subjects were 2,5 with mean estimated GFR values was 40 ml/minutes per 1,73 m2 (range 4,6 – 59 ml/minutes per 1,73 m2). Conclusion: There was negative correlation between CKD and CSVD. Further studies are needed with larger sample to determine cut off point for estimated GFR values to perform head MRI in CSVD, also to determine relationship of CSVD total score with other risk factors."

"Latar belakang: Pemeriksaan MRI pada glioblastoma dapat membantu diagnosis dengan tingkat akurasi tinggi. Nilai ADC pada MRI bisa menjadi indikator prognosis, meskipun belum sering diterapkan di Indonesia. Penelitian ini dilakukan untuk memahami peran nilai ADC dalam meningkatkan prediksi kesintasan pasien glioblastoma.Tujuan: Mengkaji angka kesintasan pasien glioblastoma yang mendapatkan terapi kemoradiasi serta hubungannya dengan nilai ADC dan faktor lainnya.Metode: Angka kesintasan dan nilai ADC minimum diambil dari pemeriksaan MRI kepala post-operasi, pre-kemoradiasi pada 20 pasien dari periode 2017 hingga 2023 yang memenuhi kriteria penelitian. Analisis kesintasan dilakukan dengan metode Kaplan-Meier. Uji Log Rank digunakan untuk mengevaluasi pengaruh faktor-faktor determinan termasuk nilai ADC terhadap kelangsungan hidup.Hasil: Rerata usia sampel dalam pemelitian ini adalah 43,6 +/- 16,4 tahun. Terdapat 14 pasien laki-laki (70%), dan 6 pasien perempuan (30%). sebanyak 6 pasien (30%) memiliki nilai ADC ≥ 0,8 x 10-3 mm2/s dan terdapat 14 pasien (70%) memiliki nilai ADC < 0,8 x 10-3 mm2/s. Analisis kesintasan memperlihatkan perbedaan median kesintasan hidup pada kelompok nilai ADC ≥ 0,8 x 10-3 mm2/s dan < 0,8 x 10-3 mm2/s, yaitu sebesar 12 bulan dan 10 bulan dengan nilai p=0,850.Kesimpulan: Pasien dengan nilai ADC < 0,8 x 10-3 mm2/s memiliki tren kesintasan yang lebih singkat dua bulan dibandingkan dengan pasien dengan nilai ADC ≥ 0,8 x 10-3 mm2/s yang masing-masing median kesintasannya sebesar 10 bulan dan 12 bulan.

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Background: MRI examinations for glioblastoma can aid in diagnosis with a high level of accuracy. The Apparent Diffusion Coefficient (ADC) value in MRI can serve as a prognostic indicator, although it has not been widely applied in Indonesia. This study was conducted to understand the role of ADC values in improving the prediction of survival in glioblastoma patients.

Objective: To examine the survival rates of glioblastoma patients undergoing chemoradiation therapy and its relationship with ADC values and other factors.

Methods: Survival rates and minimum ADC values were extracted from post- operative, pre-chemoradiation head MRI examinations of 20 patients meeting the study criteria from the period 2017 to 2023. Survival analysis was performed using the Kaplan-Meier method, and the Log Rank test was employed to evaluate the impact of determinants, including ADC values, on survival.

Results: The mean age of the sample in this study was 43.6 +/- 16.4 years. There were 14 male patients (70%) and 6 female patients (30%). Six patients (30%) had ADC values ≥ 0.8 x 10-3 mm2/s, while 14 patients (70%) had ADC values < 0.8 x 10-3 mm2/s. Survival analysis revealed a median survival difference in the ADC ≥ 0.8 x 10-3 mm2/s and < 0.8 x 10-3 mm2/s groups, namely, 12 months and 10 months, with a p-value of 0.850.

Conclusion: Patients with ADC values < 0.8 x 10-3 mm2/s had a trend of two months shorter survival compared to patients with ADC values ≥ 0.8 x 10-3 mm2/s whose median survival was 10 months and 12 months."

"Latar belakang:Atresia bilier merupakan salah satu penyebab ikterus pada neonatus yang patologis. Tatalaksana primer pada atresia bilier adalah prosedur portoenterostomi (Kasai). Tanpa tatalaksana yang adekuat, bayi dengan atresia bilier dengan cepat mengalami fibrosis dan sirosis hepar. Penelitian sebelumnya menunjukkan potensi ultrasonografi shearwave elastography (SWE) sebagai metode penilaian derajat fibrosis hepar secara kuantitatif dan cepat. Penelitian ini bertujuan mencari hubungan antara penilaian SWE dengan keberhasilan prosedur Kasai.Metode : Dilakukan studi kasus kontrol untuk menilai hasil SWE pada 23 pasien atresia bilier (11 berhasil, 12 tidak berhasil) yang menjalani prosedur Kasai di RS Cipto Mangunkusumo. Kemudian dicari rerata nilai tiap kelompok dan ditentukan titik potong SWE untuk memprediksi keberhasilan prosedur Kasai. Dilakukan juga analisis multivariat regresi logistik  pada variabel yang signifikan secara statistik, disajikan dalam bentuk odds ratio (OR).Hasil : Terdapat perbedaan bermakna secara statistik pada variabel nilai SWE (p=0,003) dan nilai bilirubin praoperasi (p=0,005). Didapatkan nilai titik potong SWE untuk menentukan keberhasilan prosedur Kasai sebesar 2,2 m/s atau 14,3 kPa (sensitivitas 75% dan spesifisitas 82%). Pada analisis multivariat didapatkan nilai OR=13,50 (p=0,011) untuk variabel nilai SWE. Dari analisis multivariat dapat ditentukan probabilitas keberhasilan prosedur Kasai dengan nilai SWE di bawah 2,2 m/s sebesar 78%.Kesimpulan : Penelitian ini menunjukkan SWE dapat digunakan sebagai salah satu prediktor keberhasilan prosedur Kasai pada pasien atresia bilier.

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Background: Biliary atresia is one of the many etiologies of pathological jaundice in neonates. Primary treatment for biliary atresia is Kasai procedure. Without adequate treatment, biliary atresia often progresses into fibrotic and cirrhosis of the liver. Earlier studies show the ability of shearwave elastography (SWE) as a method to quantify the degree of liver fibrosis. This study aims to search a correlation between SWE result and the success of Kasai Procedure.

Method : This is a case-control study, assessing the SWE value of 23 patients with biliary atresia (11 successful, 12 unsuccessful) who underwent Kasai procedure in Cipto Mangunkusumo general hospital. We determined the average of SWE value of each group and established a cutoff value to predict the success of Kasai procedure.

Results : There are statistically different values between two groups, such as SWE value (p=0,003) and bilirubin value before procedure (p=0,005). The optimal cutoff point of SWE value to predict the success of Kasai procedure is 2,2 m/s or 14,3 kPa (sensitivity 75%, specificity 82%). Multivariate analysis reveals the usefulness of SWE in predicting the success of Kasai procedure, with OR=13,50 (p=0,011). The probability of successful Kasai procedure in subjects with SWE value less than 2,2 m/s is 78%.

Conclusion : This study shows SWE can be used as a predicting factor for the success of the Kasai procedure in biliary atresia."

"Menilai tingkat akurasi Node-RADS dalam mendiagnosis metastasis kelenjar getah bening regio leher pada pasien dengan karsinoma sel skuamosa di kepala dan leher.

Metode: Sebanyak 221 sampel kelenjar getah bening dari 40 pasien yang memenuhi kriteria penelitian studi potong lintang yang menjalankan pemeriksaan CT scan leher dengan kontras, dilakukan operasi diseksi leher, dan memiliki hasil pemeriksaan histopatologi dari tahun 2020 hingga 2023. Dilakukan analisis bivariat antara Node-RADS dan histopatologi menggunakan Mc Nemar test dan Kappa Cohen R.

Hasil: Sistem skoring Node-RADS memiliki nilai diagnostik yang tidak terlalu berbeda dengan histopatologi dengan p = 0,76. Sistem skoring Node-RADS memiliki nilai Kappa Cohen 0,725, masuk kedalam substansial agreement. Hasil rasio konkordans pada skoring Node-RADS yang tinggi sebesar 88,2%, Sensitivitas 87,3%, Spesifisitas 88,6%, Nilai Duga Positif 75,3%, Nilai Duga Negatif 94,5%, LR+ 7,2, LR- 14%.

Kesimpulan: Node-RADS memiliki nilai akurasi yang cukup tinggi dan dapat dipertimbangkan sebagai metode diagnostik metastasis kelenjar getah bening regio leher pada pasien dengan karsinoma sel skuamosa di kepala dan leher.

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Squamous cell carcinoma is generally associated with metastases to the lymph nodes of the cervical region. Ricently,there have been attemts to standardize radiology reporting in oncology cases with the adoption of the Reporting and Data Systems (RADS). Node-RADS 1.0 aims to improve reporting of regional and distant lymph nodes in cancer patients by providing imaging criteria for size and configuration, facilitating a standardization system in reporting lymph nodes. However, there have been no reports regarding the suitability of Node-RADS in head and neck squamous cell carcinoma patients.

Objective: Assessing the accuracy of Node-RADS in diagnosing lymph node metastases in the neck region in patients with squamous cell carcinoma of the head and neck.

Method: A total of 221 lymph node from 40 patients who met the criteria for a cross-sectional research study, underwent a CT scan of the neck with contrast, neck dissection surgery, and had histopathological examination results from 2020 to 2023. Bivariate analysis was carried out between Node-RADS and histopathology using the McNemar test and Cohen's Kappa (κ).

Results: Node-RADS scoring system had a diagnostic value that was not significantly different from histopathology, with p = 0.76. The Node-RADS scoring system has a Cohen's Kappa value of 0.725, indicating substantial agreement. The concordance ratio results for Node-RADS scoring were high, with 88.2% concordance, a sensitivity of 87.3%, specificity of 88.6%, positive predictive value of 75.3%, negative predictive value of 94.5%, LR+ of 7.2, and LR- of 14%.

Conclusion: Node-RADS has a high accuracy value and can be considered as a diagnostic method for lymph node metastases in the neck region in patients with squamous cell carcinoma of the head and neck."