PERBANDINGAN KUANTITAS WASHOUT ANTARA FASE DELAYED DAN FASE VENA CT SCAN ABDOMEN MULTIFASE PADA KARSINOMA HEPATOSELULER

Arif Budiman, dr. Yana Supriatna, Ph.D Sp.Rad (K) RI.; dr. Sudarmanta, Sp. Rad (K) RI.

2024 | Tesis | S2 Kedokteran Klinik

Latar Belakang : Kuantitas tumor washout fase vena atau delayed merupakan salah satu indikator kuat dalam menentukan diagnosis karsinoma hepatoseluler yang tipikal selain lesi hipervaskular pada fase arteri. Pemeriksaan tumor washout sejauh ini hanya dinilai secara subyektif kualitatif, penilaian yang bersifat obyektif dengan menghitung kuantitas washout jarang dilakukan, sehingga menentukan fase CT Scan Abdomen terbaik untuk menilai washout sangat berarti untuk meningkatkan akurasi diagnosis.

Tujuan : Membandingkan kuantitas washout antara fase delayed dan fase vena CT Scan Abdomen Multifase pada pasien karsinoma hepatoseluler.

Metode: Penelitian ini termasuk jenis analitik observasional retrospektif dengan rancangan cross sectional, menggunakan data sekunder pasien yang menjalani CT Scan Abdomen Multifase di RSUP dr Sardjito. Pasien yang memenuhi kriteria inklusi dan ekslusi yang dijadikan subyek penelitian sebanyak 51 orang. Diukur densitas lesi hepar dan parenkim hepar pada fase prekontras, arteri, vena dan delayed yang selanjutnya diformulasikan dengan rumus tertentu untuk menghasilkan nilai kuantitas washout. Data kemudian dianalisis dengan uji t berpasangan.

Hasil : Analisis statistik menunjukan terdapat perbedaan kuantitas washout antara fase delayed dan fase vena pada perhitungan menggunakan rumus washout absolut dan relatif (p < 0> 0,05). Angka rerata±SD fase vena dibandingkan dengan fase delayed, WOAbs 19,3±16,9 berbanding 38,1±25,4, WORel 7,0±6,8 berbanding 13,4±8,2 VPAR/DPAR 142,2±36,7 berbanding 143,6±36,0.

Kesimpulan : Terdapat perbedaan kuantitas washout lesi KHS pada fase vena dan fase delayed, Nilai rerata lebih tinggi didapatkan pada fase delayed dibandingkan dengan fase vena bila menggunakan rumus perhitungan washout absolut dan washout relatif.

Background : The quantity of tumor washout in the venous or delayed phase is one of the strong indicators in determining the diagnosis of typical hepatocellular carcinoma, in addition to the hypervascular lesion in the arterial phase. Tumor washout assessment has so far only been evaluated qualitatively in a subjective manner, with objective assessment by calculating the washout quantity rarely being done, so determining the best abdominal CT scan phase to assess washout is very significant to improve the accuracy of the diagnosis.

Objective : To compare the quantity of washout in the delayed phase versus the venous phase of multiphase abdominal CT scans in patients with hepatocellular carcinoma.

Method : This research is a retrospective observational analytic study with a cross-sectional design, using secondary data of patients who underwent multiphase abdominal CT scans at dr. Sardjito Hospital. Patients who met the inclusion and exclusion criteria and were included as research subjects were 51 people. The density of the hepatic lesions and hepatic parenchyma in the pre-contrast, arterial, venous, and delayed phases were measured, and then formulated with a certain formula to generate the washout quantity values. The data was then analyzed using a paired t-test.

Results : Statistical analysis showed that there was a difference in the quantity of washout in the delayed phase compared to the venous phase when calculated using the absolute and relative washout formulas (p < 0> 0.05). The mean±SD values for the venous phase compared to the delayed phase were, WOAbs 19.3±16.9 versus 38.1±25.4, WORel 7.0±6.8 versus 13.4±8.2, VPAR/DPAR 142.2±36.7 versus 143.6±36.0.

Conclusion : There was a difference in the quantity of washout of HCC lesions in the venous phase and delayed phase. The mean values were higher in the delayed phase compared to the venous phase when using the formulas for absolute washout and relative washout.

Kata Kunci : Karsinoma hepatoseluler, kuantitatif washout, vena, delayed