Perbedaan Nilai Rasio ADC pada Meningioma Sellar dan Makroadenoma Hipofisis
Fayz Badar Nahdi, dr. Yana Supriatna, Ph.D, Sp. Rad., Subsp. RI (K).; dr. Bambang Purwanto Utomo, Sp. Rad., Subsp. Abd (K), M. Med. Ed
2025 | Tesis | S2 Kedokteran Klinik
Latar Belakang: Makroadenoma hipofisis dan
meningioma sellar merupakan tumor jinak yang sering ditemukan di regio sellar
dan parasellar. Diferensiasi dini antara kedua jenis tumor ini penting untuk
menentukan rencana tindakan operatif yang tepat. Nilai Apparent Diffusion
Coefficient (ADC) dari pencitraan Magnetic Resonance Imaging (MRI) diusulkan
sebagai metode non-invasif untuk membantu diferensiasi ini.
Tujuan: Menilai perbedaan
nilai rasio ADC antara makroadenoma hipofisis dan meningioma sellar serta
menentukan nilai cut-off diagnostik rasio ADC.
Metode: Penelitian ini merupakan studi
observasional analitik dengan rancangan potong lintang. Subjek penelitian
adalah 24 pasien di RSUP Dr. Sardjito Yogyakarta (12 pasien meningioma dan 12
pasien makroadenoma hipofisis) yang menjalani pemeriksaan MRI kepala dengan
sekuen ADC, dan telah terkonfirmasi diagnosis histopatologi. Nilai rasio ADC
dihitung berdasarkan perbandingan nilai ADC tumor terhadap jaringan otak
normal. Analisis dilakukan menggunakan uji Independent Samples T-Test dan kurva
ROC.
Hasil: Rata-rata nilai rasio ADC pada
meningioma sebesar 1,2422 ± 0,17997, sedangkan pada makroadenoma hipofisis
sebesar 0,9963 ± 0,23513, dengan perbedaan yang signifikan (p = 0,009).
Analisis ROC menunjukkan area under the curve (AUC) sebesar 0,813. Nilai
cut-off rasio ADC sebesar 1.024 diperoleh, dengan sensitivitas 100?n
spesifisitas 66,7%.
Kesimpulan: Rasio ADC memiliki kemampuan diskriminatif
yang sangat baik untuk membedakan meningioma sellar dan makroadenoma hipofisis.
Rasio ADC dapat digunakan sebagai parameter tambahan dalam diagnosis
pre-operatif tumor di regio sellar.
Background: Pituitary
macroadenoma and sellar meningioma are two common benign tumors found in the
sellar and parasellar regions of the brain. Distinguishing between them early
on is important, especially when planning the right surgical approach. One
helpful, non-invasive method is using MRI to measure the Apparent Diffusion
Coefficient (ADC), which may assist doctors in telling these tumors apart more
accurately.
Objective: This
study aims to compare the ADC ratio values between pituitary macroadenomas and
sellar meningiomas, and to identify the best cut-off value that can help
distinguish between the two.
Methods: This
cross-sectional observational study involved 24 patients treated at Dr.
Sardjito General Hospital in Yogyakarta—12 diagnosed with meningiomas and 12
with pituitary macroadenomas. All patients underwent brain MRI with ADC
sequences, and their diagnoses were confirmed through histopathological
examination. The ADC ratio was determined by comparing the ADC value of the
tumor to that of normal brain tissue. The data were then analyzed using an
Independent Samples T-Test and ROC curve analysis to assess diagnostic
performance.
Results: The
average ADC ratio was higher in meningiomas (1.2422 ± 0.17997) compared to
pituitary macroadenomas (0.9963 ± 0.23513), and this difference was
statistically significant (p = 0.009). ROC curve analysis showed a good diagnostic
performance, with an area under the curve (AUC) of 0.813. The optimal cut-off
value for the ADC ratio was found to be 1.024, which gave a sensitivity of 100%
and a specificity of 66.7%.
Conclusion: The ADC
ratio shows strong potential in helping to distinguish sellar meningiomas from
pituitary macroadenomas. It can be a useful additional tool to support the
preoperative diagnosis of tumors in the sellar region..
Kata Kunci : Rasio ADC, makroadenoma hipofisis, meningioma sellar, MRI, DWI
