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Characterization of Classic Meningioma with Use of Conventional Magnetic Resonance and Diffusion Tensor Imaging Fatmawati, Heni; Adji, Novan Krisno; Bumi, Candra; Putri, Komang Yunita Wiryaning
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1133

Abstract

Introduction: The conventional magnetic resonance imaging (MRI) method is widely considered ‘with limited success’ in differentiating the meningioma types but may fail to localize the tumor occupation of white-matter fiber bundles accurately. Diffusion tensor imaging (DTI) is considered as an imaging modality that may elucidate the microstructure of brain tumors. We provide characteristics of meningioma using DTI-based-three-dimensional tracing of white matter to portray meningioma in a noninvasive approach and its structural contact to contiguous tumors and elucidate the influence of occupying lesions on white-matter fiber bundles. Case Presentation: A 28-year-old female presented with visuospatial disturbances and persistent headaches for 2 years. Conventional and advanced MRI studies were performed. Diffusion-weighted Images (DWI) and Apparent Diffusion Coefficient (ADC) values were measured in the lesion using routine MRI sequences. Advanced MRI using DTI was also performed. Conventional MRI outcomes showed tumor parenchyma, peritumoral edema, and compression on the circumnavigated brain tissue. There was hyperintense on DW trace image and isointense on ADC map. On T2-weighted image (T2WI) and Fluid-Attenuated Inversion Recovery (FLAIR) images, there was an increased signal intensity that demonstrated an extra-axial lesion, while T1-weighted imaging signals showed hypointensity. DTI fractional anisotropy (FA) marker is an unclear optic radiation in the concerned area, indicating the shift or destruction of the optic radiation. The mean FA values of solid-enhancing areas of meningioma were 0.28 ± 0.17. Mean ADC values (103 mm2/s) were 0.764 ± 0.172. Conclusions: Classic meningioma in this case has low intratumoral FA and high ADC. DTI displayed that intratumoral microscopic water motion is disorganized.
Sinonasal Bone Destruction caused by Frontal Meningioma Invasion related with Respiratory Tract Infection Incident: A Case Report Adji, Novan Krisno; Putri, Komang Yunita Wiryaning; Indreswari, Laksmi; Nugraha, Muhammad Yuda
Jember Medical Journal Vol. 1 No. 1 (2022)
Publisher : Faculty of Medicine, University of Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (766.779 KB) | DOI: 10.19184/jmj.v1i1.151

Abstract

Meningioma is uncommonly found in extracranial. Extracranial meningioma can be extension from primary intracranial tumors that accompany osteolytic changes in the skull or causes bone destruction. In this article, we report about intracranial meningioma in the frontal region that extend to the sinonasal bone causes bone destruction and being predisposing factor for respiratory tract infection. A 47-years old female brought to the emergency department due to dyspnea and fever since a week ago and there was found a lump in the frontal region. During the surgical procedure, there was invasion of tumor and caused sinonasal bone destruction. The endotracheal tube (ETT) can be seen from the surgical field. In this case the patient was threated pneumonia infection, it can be related as complication of sinonasal bone destruction that caused by invasion of meningioma to extracranial manifestation. The clinical important that must be informed to the patient the possibility of recurrent respiratory tract infection incidents.
Extraction of Air Gun Pellet in Lung Base Thoracic Vertebrae Region with Lateral Extracavitary Approach: A Case Report Adji, Novan Krisno; Putri, Komang Yunita Wiryaning; Indreswari, Laksmi; Nugraha, Muhammad Yuda; Habibi, Ali
Jember Medical Journal Vol. 2 No. 2 (2023)
Publisher : Faculty of Medicine, University of Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19184/jembermedicaljournal.v2i2.452

Abstract

Thoracic gunshot injuries are associated with significant morbidity and mortality, but fatal accidents from air guns are rare. Surgery in this area is challenging, especially if the gun pellet penetrates the visceral organ like the lung. In this case, we present a case of an 18-year-old male who came to the emergency department with an air gunshot (pellet) that penetrated the chest and settled in the lung base. After being shot by an air gun, the patient came with pain in the right back and weakness in both lower extremities. Based on the radiological examination, metallic corpus allienum measuring ± 0.8 x 0.7 cm has shown at the lung base as high as the Thoracic 12 vertebrae, 9.5 cm right lung laceration, right hemothorax, and emphysema subcutis on the right inferior side of hemithorax. The patient planned surgery to extract the corpus allienum through a lateral extra cavitary approach to expose the lungs at the level of the Th10-12 vertebrae. The lateral extra cavitary approach can be an alternative, less invasive method to extract foreign body lung base in front of vertebrae thoracic region.
Comparison of lipid-lactate levels between brain abscesses and brain tumors through magnetic resonance spectroscopy examination Syafa, Nahdah Ardelia; Fatmawati, Heni; Putri, Komang Yunita Wiryaning; Hairrudin; Adji, Novan Krisno
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 15, No 3, (2024)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol15.Iss3.art7

Abstract

Background: Intracranial masses are masses found in the intracranial space, such as brain abscesses and brain tumors. Magnetic Resonance Spectroscopy (MRS) examination is a noninvasive examination procedure with magnetic resonance regarding chemical composition or metabolites. One of the metabolites examined in MRS is lipid-lactate which will appear or increase if there are certain abnormalities such as in abscesses and brain tumors.Objective: This study analyzed the difference in lipid-lactate levels between brain abscess and brain tumor through MRS examination.Methods: This research adopted an observational analytic approach with a cross-sectional design. Samples in this study were brain abscess and brain tumor patients examined using MRI and MRS at Siloam Jember Hospital from June 2018 to October 2023. The sampling method employed encompassed a total sampling of 45 patients with 15 brain abscesses and 30 brain tumors. Results: The results of this study showed that the lipid-lactate levels of all brain abscess patients increased by 15 patients (100%), while in brain tumors, lipid-lactate levels increased by 19 patients (63.3%) and decreased by 11 patients (36.7%). The mean rank of lipid-lactate levels in brain abscesses was 14101,93 while in brain tumors was 6220,69. The statistical analysis results using the Mann-Whitney comparison test obtained a p-value of 0.008 (<0.05), meaning there is a significant difference.Conclusion: There is a significant difference in lipid-lactate levels in brain abscesses and brain tumors.