KESESUAIAN ANTARA SPECTRAL DOPPLER ULTRASONOGRAFI VENA HEPATICA DENGAN DERAJAT STEATOSIS HEPATIS DIFUS HASIL PEMERIKSAAN CT SCAN ABDOMEN PRA KONTRAS PADA NON ALCOHOLIC STEATOSIS HEPATIS
NUNIK ROYYANI, Prof. dr. Arif Faisal, Sp.Rad (K), DHSM.; dr. Henry Kusumo Husodoputro, Sp.Rad (K)
2017 | Tesis-Spesialis | SP RADIOLOGILatar Belakang. Non alcoholic steatosis hepatis tidak statis, dapat berkembang menjadi steatosis hepatitis, cirrhosis hepatis hingga karsinoma hepatoseluler. Diagnosis awal dan terapi yang tepat untuk non alcoholic steatosis hepatis menghalangi berkembangnya cirrhosis hepatis. Steatosis hepatis menimbulkan pembengkakan hepatosit menyebabkan kompresi vena hepatica, menurunkan compliance pembuluh darah hepar dan penurunan phasicity vena hepatica. CT scan abdomen telah terbukti bermanfaat dalam diagnosis dan menentukan derajat steatosis hepatis difus, namun menghasilkan radiasi. Ultrasonografi spectral doppler penting dalam evaluasi pembuluh darah hepar dan penyakit parenkhim hepar. Perubahan parenkhm hepar dapat mengganggu compliance vena hepatica, ditunjukkan oleh specral abnormal. Tujuan.Untuk mengetahui tingkat kesesuaian antara spectral doppler vena hepatica dengan derajat steatosis hepatis difus hasil CT scan abdomen pra kontras Bahandan Cara. Penelitian analitik korelatif cross sectional. Subyek 19 pasien steatosis hepatis difus hasil pemeriksaan CT scan abdomen pra kontras, dilakukan konfirmasi ultrasonografi spectral doppler. Interpretasi CT scan dan konfirmasi ultrasonografi spectral doppler oleh dokter spesialis radiologi. Pengambilan sampel consecutive sampling non random. Penelitian dilakukan RSUP Dr. Sardjito Yogyakarta pada bulan Maret-April 2017. Analisis uji statistic dengan uji korelasi Spearman. HasildanPembahasan. Spectral abnormal (biphasic dan monophasic) jumlahnya lebih dominan dibandingkan spectral normal l triphasic. Spectral abnormal sebanyak 12 (63,16%) subyek (7 (36,81%) biphasic dan 5 (26,35%) monophasic). Spectral abnormal pada derajat ringan-sedang 3 (15,75%) (biphasic 2 (10,50%) dan monophasic 1(5,25%)) dan pada derajat sedang-berat 9 (47,41%) (biphasic 5 (26,31%) dan monophasic 4 (21,1%). Secara statistic tidak terdapat hubungan yang bermakna antara spectral doppler vena hepatica dan derajat steatosis hepatis difus hasil CT scan abdomen pra kontras dengan nilai p = 0,77. Kesimpulan. Jumlah spectral doppler abnormal (biphasic dan monophasic) subyek steatosis hepatis difus lebih dominan dibandingkan spectral doppler normal triphasic. Tidak terdapat hubungan yang bermakna antara spectral doppler vena hepatica dengan derajat steatosis hepatis difus hasil pemeriksaan CT scan abdomen pra kontras.
Background.Non-alcoholic hepatic steatosis can develop from simple to steatosis hepatitis, cirrhosis hepatis and hepatocellular carcinoma. Early diagnosis and appropriate therapy help to prevent cirrhosis hepatis. Hepatic steatosis causes hepatocyte swelling which causes compression of hepatic vein, reducing hepatic vessel compliance and reducing hepatic phasicity. Abdominal CT has proven use in diagnosing and determining diffuse hepatic steatosis grade, but it produce radiation. Doppler US is important in the evaluation of hepatic vasculare and parenchym. The change of the hepatic parenchyma may alter hepatic vein compliance, showed by abnormal doppler waveform. Objective.To find the correlation between hepatic vein doppler spectral and diffuse hepatic steatosis grade from pre-contrast CT. Material and Methods.This is a cross-sectional correlation analysis study. Nineteen subjects with diffuse hepatic steatosis from pre-contrast CT underwent doppler US confirmation. Interpretation of abdominal CT and doppler US confirmation was evaluated by a radiologist. Sample were taken by consecutive sampling non random. This study performed in Dr. Sardjito Hospital Yogyakarta, in Maret-April 2017. The data were analised by Spearman test Result and Discussion.Abnormal spectral biphasic and monophasic was dominant than normal spectral triphasic. Abnormal spectral observed in 12 (63,16%) subject (7 (36,81%) biphasic dan 5 (26,35%) monophasic). Abnormal spectral with mild-moderate hepatic steatosis observed in 3 (15,75%) (biphasic 2 (10,50%) dan monophasic 1(5,25%)) and with moderate-severe hepatic steatosis observed in 9 (47,41%) (biphasic 5 (26,31%) dan monophasic 4 (21,1%). There is no statistically significant correlation between hepatic vein doppler spectral and diffuse hepatic steatosis degree (p = 0.7; r = 0.07). Conclusion.Abnormal spectral (biphasic and monophasic) were observed greater than normal triphasic spectral in diffuse hepatic steatosis subjects. No significant correlation between hepatic vein doppler spectral and diffuse hepatic steatosis grade from abdominal pre-contrast CT.
Kata Kunci : Steatosis hepaticus difus, Ultrasonografi doppler, Spectral vena hepatica, CT Scan abdomen pra kontras, Derajat steatosis hepatis difus, Diffuse Hepatic Steatosis; Hepatic Steatosis Grade; Abdominal Pre contrast CT; Doppler Ultrasonography; Hepatic Vein S
