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All Journal Medical Journal of Indonesia Damianus Journal of Medicine
Siregar, Trifonia Pingkan
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Health Professions Medicine & Pharmacology Public Health

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Gambaran Kehamilan Ektopik pada Magnetic Resonance Imaging Siregar, Trifonia Pingkan; Djajasasmita, Fitriyadi Kusuma; Hellyanti, Tantri; Stascia, Stefani
Bahasa Indonesia Vol 22 No 3 (2023): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25170/djm.v22i3.3338

Abstract

Pendahuluan: Kehamilan ektopik (KE) adalah kehamilan dengan letak implantasi di luar kavum uterus. Diagnosis KE ditegakkan melalui tes urin, ultrasonografi, penilaian level β-hCG, dan kuretase. Ultrasonografi transvaginal adalah modalitas imejing terpilih, meskipun pada beberapa kondisi, sulit menentukan antara kehamilan awal atau KE melalui Ultrasonografi transvaginal. Pada KE dapat terjadi juga beberapa gambaran kelainan di intra-uterus/endometrium. Kasus: Seorang wanita 32 tahun dengan riwayat kehamilan ektopik 2 kali sebelum dan sekarang dengan periode menstruasi terlambat 2 bulan. Tes kehamilan positif dengan kadar β-hCG 24,411 mIU/ml. Pasien menjalani TVU dan dicurigai adanya massa intra uterin tanpa ditemukan struktur kantung gestasi (GS). Pasien diduga menderita gestational trophoblastic disease (GTD) karena pada pemeriksaan laboratorium didapatkan hasil tes kehamilan positif dan peningkatan kadar β-hCG, dan USG tidak menunjukkan adanya GS intra/ekstra kavum uteri. Pasien menjalani MR pelvis dengan hasil dicurigai adanya kantung kehamilan di adneksa kiri dan menunjukkan perubahan endometrium yang menyerupai lesi massa. Pasien menjalani operasi laparotomi dan mengungkapkan kehamilan ektopik di dalam tuba Fallopi kiri dengan hemoperitoneum masif, diagnosis ini dikonfirmasi pada hasil patologis. Simpulan: Apabila sulit menegakkan diagnosis dengan ultrasonografi transvaginal, maka modalitas MRI menjadi pilihan karena memiliki kemampuan diagnosis yang lebih baik. Pengetahuan akan gambaran klinis dan MRI pada KE sangat penting untuk menentukan diagnosis yang akurat dan penatalaksanaan yang tepat.
Tumor apparent diffusion coefficient value and ratio in magnetic resonance imaging on cervical cancer Siregar, Trifonia Pingkan; Wanandi, Septelia Inawati; Darmiati, Sawitri; Kusuma, Fitriyadi; Sekarutami, Sri Mutya; Lisnawati; Prihartono, Joedo; Ilyas, Muhammad; Amalia, Ginva; Elfahmi, Khalida Ikhlasiya Tajdar Gefariena
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257715

Abstract

BACKGROUND Diffusion-weighted magnetic resonance imaging (DW-MRI) is a noninvasive, non-contrast sequence for cancer detection. Research involving DW-MRI in cervical cancer has revealed lower apparent diffusion coefficient (ADC) values. This study aimed to evaluate the difference in tumor ADC values and ADC ratios (tumor-to-urine and tumor-to-muscle) with respect to tumor staging (early versus late) and histopathology (squamous cell carcinoma versus adenocarcinoma). METHODS This retrospective study included 56 patients with cervical cancer, divided into early- and late-stage groups. DW-MRI was performed in all patients, and the tumor ADC value, ADC ratio between the tumor and urine (ADC ratiot−u), and ADC ratio between the tumor and gluteal muscle (ADC ratiot−m) were measured. Statistical methods were employed to assess the difference in the tumor ADC value, ADC ratiot−u, and ADC ratiot−m with respect to cervical cancer stages and histopathological findings. RESULTS The median tumor ADC value was lower in the early-stage group than in the late-stage cervical cancer (0.75 × 10−3 mm²/s versus 0.8 × 10−3 mm²/s, p = 0.022). However, no differences were observed in ADC ratiot−u and ADC ratiot−m concerning the tumor staging, nor in ADC value, ADC ratiot−u, and ADC ratiot−m concerning histopathological findings (p = 0.29, 0.67 and 0.35, respectively), with no significant differences in the ADC ratiot−u (p = 0.153) and ADC ratiot−m (p = 0.260). In receiver operating characteristic analysis, the tumor ADC value was 75.0% sensitive and 50.0% specific in predicting late-stage cervical cancer with a cut-off value of 0.750 × 10−3 mm2/s. CONCLUSIONS The median tumor ADC value in early-stage patients was significantly lower than in the late-stage patients, suggesting that tumor ADC value has valuable potential for characterizing cervical cancer staging.
Co-Authors Amalia, Ginva Darmiati, Sawitri Djajasasmita, Fitriyadi Kusuma Elfahmi, Khalida Ikhlasiya Tajdar Gefariena Fitriyadi Kusuma Hellyanti, Tantri Joedo Prihartono Lisnawati Muhammad Ilyas Sekarutami, Sri Mutya SEPTELIA INAWATI WANANDI Stascia, Stefani