Perbandingan Morfologi Vesica Felea, Contractility Index Dan Ketebalan Triangular Cord Sign Dalam Pemeriksaan Ultrasonografi Abdomen Dua Fase Terhadap Hasil Kolangiografi Intraoperatif Untuk Diagnosis Atresia Bilier

Brenda Desy Romadhon, Dr. dr. Bambang Supriyadi, Sp.Rad (K) MSK, MM.; dr. Evi Artsini, Sp.Rad(K)-TR.

2025 | Tesis | S2 Kedokteran Klinik

Latar Belakang: Atresia bilier (AB) adalah kelainan fibroobliteratif progresif saluran empedu intra dan ekstrahepatik yang menyebabkan kolestasis pada neonatus. Ultrasonografi abdomen dua fase menjadi modalitas awal diagnosis AB di Indonesia.

Tujuan: mengetahui perbedaan, nilai cut-off dan akurasi diagnostik morfologi vesica felea (VF), contractility index (CI), dan ketebalan triangular cord sign (TACS) pada ultrasonografi abdomen dua fase terhadap hasil kolangiografi intraoperatif untuk diagnosis AB.

Metode: Uji diagnostik analitik observasional dengan desain cross-sectional menggunakan data sekunder pasien kolestasis di RS Sardjito (Agustus 2020–September 2024). Sampel diambil secara consecutive non-random sampling (n=72).

Hasil: Volume VF prepandrial, tipe morfologi VF, contractility index dan ketebalan TACS menunjukkan perbedaan bermakna (p<0>

Kesimpulan: Parameter ultrasonografi abdomen dua fase berupa volume VF prepandrial?142 mm³, CI?71,58%, ketebalan TACS?2,03 mm dan morfologi vesica felea tipe III dapat mendiagnosis AB. Kombinasi parameter meningkatkan sensitivitas sempurna, sementara ketebalan TACS memberikan performa diagnostik tertinggi. Temuan ini mendukung USG sebagai alat skrining efektif untuk AB sebelum konfirmasi kolangiografi intraoperatif.

Background: Biliary atresia (BA) is a progressive fibro-obliterative disorder of the intra- and extrahepatic bile ducts, causing cholestasis in neonates. Two-phase abdominal ultrasound is the initial diagnostic modality for BA in Indonesia.

Objective: To determine the differences, cut-off values, and diagnostic accuracy of gallbladder (GB) morphology, contractility index (CI), and triangular cord sign (TACS) thickness in two-phase abdominal ultrasound compared to intraoperative cholangiography for BA diagnosis.

Methods: An observational analytic diagnostic test with a cross-sectional design using secondary data from cholestatic infants at Sardjito Hospital (August 2020–September 2024). Consecutive non-random sampling was used (n=72).

Results: Preprandial GB volume, GB morphology type, CI, and TACS thickness showed significant differences (p<0>

Conclusion: Two-phase abdominal ultrasound parameters including preprandial GB volume ?142 mm³, CI ?71,58%, TACS thickness ?2,03 mm, and type III GB can diagnose AB. The combination of these parameters yields perfect sensitivity, while TACS thickness demonstrates the highest diagnostic performance. These findings support the use of ultrasound as an effective screening tool for AB prior to confirmation by intraoperative cholangiography.

Kata Kunci : atresia bilier, ultrasonografi abdomen dua fase, morfologi vesica felea, contractility index, ketebalan TACS