AKURASI TEMUAN CT SCAN DAN PREDIKSI PENEGAKAN DIAGNOSIS NEUROBLASTOMA

NUR HAYATI, dr. Yana Supriatna, PhD, SpRad(K).; dr. Sri Retna Dwidanarti, SpRad(K)Onk.

2017 | Tesis-Spesialis | SP RADIOLOGI

Latar Belakang. Massa abdomen pada neonatus dan anak-anak selalu mendapatkan perhatian karena massa di lokasi ini sering merupakan massa maligna. Pencitraan radiologis memainkan peran penting dalam diagnosis keganasan anak. Penelitian ini ditujukan untuk mengetahui akurasi diagnostik CT scan dengan standar emas pemeriksaan patologi anatomi. Metode Penelitian. Rancangan penelitian ini adalah penelitian observasional analitik retrospektif. Pengambilan sampel dilakukan dengan metode consecutive sampling non random. Subjek penelitiannya adalah foto CT scan abdomen. Dilakukan uji diagnostik dan uji regresi logistik untuk menilai akurasi serta kekuatan prediksi foto CT scan abdomen untuk menegakkan diagnosis neuroblastoma. Hasil Penelitian. Neuroblastoma adalah tumor abdomen anak yang paling sering dijumpai, yaitu 37,50%, kemudian nefroblastoma 20,83%, dan tumor sel germinal 18,75%. Foto CT scan abdomen memiliki sensitivitas, spesifisitas, dan akurasi berturut-turut sebesar 88,89%, 93,33%, dan 91,67%. Karakteristik lesi yang memiliki nilai diagnostik cukup tinggi untuk menegakkan diagnosis neuroblastoma adalah lokasi retroperitoneal non-renal, kalsifikasi dan vascular encasement. Karakteristik batas tidak tegas, kalsifikasi dan vascular encasement pada foto CT scan abdomen merupakan prediktor yang kuat untuk diagnosis neuroblastoma, dengan odds ratio masing-masing 3,9 (CI 95% 1,10-13,80), 7 (CI 95% 1,82-26,887) dan 17,5 (CI 95% 4,03-76,00). Kesimpulan. Foto CT scan abdomen memiliki akurasi yang tinggi untuk penegakan diagnosis neuroblastoma. Karakteristik lokasi retroperitoneal nonrenal, kalsifikasi dan vascular encasement merupakan prediktor diagnosis neuroblastoma.

Background. Abdominal mass in neonates and children always got attention because the masses at this location was often a malignant mass. Radiological imaging played an important role in the diagnosis of malignancy of children. The purpose of this study was to determine the diagnostic accuracy of CT scan to diagnose neuroblastoma. Material and methods. The study design was a retrospective observational analytic study to test the accuracy of abdominal CT scan. Sampling method was non-random consecutive sampling. The subject of this study were images of abdominal CT scan. Diagnostic test dan logistic regression test was performed. Result. Neuroblastoma is the most common paediatric abdominal tumor, which is 37,50%, then nephroblastoma 20,83%, and germinal cell tumor 18,75%. Abdominal CT scan had sensitivity, specificity, and accuracy of 88.89%, 93.33%, and 91.67%, respectively. Non-renal retroperitoneal sites, calcification and vascular encasement were radiological features that have high sensitivity, specificity, and accuracy value for diagnosing neuroblastoma. The indistinct margin, calcification and vascular encasement were good predictors in diagnosing neuroblastoma, with odds ratio were 3,9 (CI 95% 1,10-13,80), 7 (CI 95% 1,8226,887) and 17,5 (CI 95% 4,03-76,00) respectively. Conclusion. CT scan has high accuracy to diagnose neuroblastoma. Non-renal retroperitoneal sites, indistinct margin, calcification and vascular encasement are predictors of neuroblastoma diagnosis.

Kata Kunci : Neuroblastoma, CT scan abdomen, akurasi diagnostik, Neuroblastoma, CT scan, accuracy diagnostic.