Uji diagnostik ultrasonography pada penderita hasil pemeriksaan intravenous pyelography (IVP) non visualisasi ren sampai menit 120

MAJDAWATI, Ana, dr. Henry Kusumo Husodoputro, Sp.Rad(K)

2008 | Tesis | S2 Ilmu Kedokteran Klinik

Penelitian ini bertujuan untuk mendapatkan validitas pemeriksaan ultrasonography (USG) pada penderita hasil pemeriksaan intravenaous pyelography (IVP) non visualisasi ren sampai menit 120. Penelitian ini merupakan penelitian uji diagnostik yang dilakukan di Radiologi RSUP Dr. Sardjito, Yogyakarta antara Januari 2006 sampai Desember 2007. Didapatkan sampel penelitian sebanyak 50 subyek, usia 31-63 tahun dengan jumlah laki-laki 23 dan wanita 27. Terdiri dari 25 subyek non visualisasi ren dextra atau sinistra sampai menit 120, dan 25 subyek ren dextra atau sinistra atau keduanya tervisualisasi. Seluruh subyek dilakukan pemeriksaan USG ren dan scintigraphy renal. Penilaian USG ren meliputi, 1). Ukuran ; 2). Echostructur; 3). Batas cortexmedulla; 4). tebal cortex dan 5) kelainan ren (hidronefrosis, massa, cyste, batu), dan masing masing diberi nilai satu bila hasil abnormal. Score ren dianggap abnormal bila nilai 1-5 dan dianggap normal bila score 0. Renogram ren fase II, dianggap normal bila fungsi ren baik (kurva fase II mencapai peak point sebelum 5 menit; F0) dan dianggap abnormal bila fungsi ren menurun ringan/sedang/berat/minimal/non fungsi (kurva fase II tidak mencapai peak point; F1-6). Jumlah nilai USG yang didapatkan dilakukan uji diagnostik terhadap hasil renogram fase II pada ren yang sama. Validitas USG untuk mendiagnosis gangguan fungsi ren sebagai berikut: sensitifitas 91,7%, spesifisitas 88,5%. Ultrasonography ren memiliki validitas yang baik untuk mendiagnosis kelainan yang berakibat penurunan fungsi ren. Hal ini perlu diperhatikan untuk mengalihkan usulan pemeriksaan IVP kepada pemeriksaan USG, terutama pada penderita dengan klinis insufisiensi renal (kreatinin borderline 1,5-1,9 mg/dl) karena bahan kontras memiliki efek nefrotoksik yang dapat memperberat fungsi rennya

The aim of the study is find the validity of investigation by using the ultrasonography (USG) for subjects with result of renal non-visualization intravenous pyelography (IVP) investigation up to 120 minutes. It is a diagnostic investigation, being conducted in the Radiology of RSUP Dr. Sardjito, Yogyakarta, from January 2006 to December 2007. The sample of 50 subjects, 31-63 in age, and 23 male and 27 female in sex is collected. It consists of 25 subjects with dextral or sinistra renal non-visualization up to 120 minutes, and 25 subjects with renal dextral or sinistra conditions or both are visualized. All the subjects are investigated by using the renal USG and scintigraphy. The assessment of the renal USG include: 1) Size; 2) Echostructure, 3) Limit of cortex-medulla; 4) the thickness of cortex; and 5) renal disorders (hydronephrosis, mass, cysts, stone), and each is given a score 1 if the result is abnormal. The renal score is considered as abnormal if the score is 1-5 and considered as normal if the score is 0. The renal renogram of phase II is considered as normal is the renal function is good (the curve of phase II achieves a peak point before 5 minutes; F0) and considered as abnormal if the renal function decreases in light/moderate/severe/ minimal/non-functional manner (the curve of phase II did not achieve the peak point; F1-6). The number of USG scores obtained is diagnostically examined compared with result of the renogram of phase II for the same renal anatomy. The validity of USG to diagnose the disorder of renal function is as follows: the sensitivity is 91.7% and the specificity is 88.5%. The renal Ultrasonography has a good validity to diagnose the disorder resulting in the decrease of renal function. It is necessary to observe in order to turn from the proposal of IVP investigation into that of the USG investigation, especially among subjects with clinical renal insufficiency because contrast materials have nephrotoxic effects, which can exacerbate the renal function.

Kata Kunci : Intravenous pyelography,Non visualisasi ren sampai menit (120),Scintigraphy ren fase II,Ultrasonography,Uji diagnostik, intravenous pyelography, renal non-visualization up to 120 minutes, renal scintigraphy of phase II, ultrasonography, diagnostic test