Cardiotoraks

Uji Sensitivitas dan Spesifisitas Radiografi Toraks dibandingkan Pemeriksaan
Ekokardiografi dalam Mendeteksi Kelainan Katup Mitral pada Pasien dengan

Pembesaran Atrium Kiri
TESIS
Diajukan sebagai salah satu syarat untuk memperoleh gelar spesialis radiologi
BRIAN LUCAS
0906647766
PROGRAM PENDIDIKAN DOKTER SPESIALIS I RADIOLOGI
FAKULTAS KEDOKTERAN
UNIVERSITAS INDONESIA
JAKARTA
AGUSTUS 2013
Uji sensitivitas…, Brian Lucas, FK UI, 2013

HALAMAN PERNYATAAN ORISINALITAS
Tesis ini adalah hasil karya saya sendiri, dan semua sumber baik yang dikutip maupun
dirujuk telah saya nyatakan dengan benar
Nama : Brian Lucas
NPM : 0906647766
Tanda tangan :
Tanggal : 21 Agustus 2013
ii Universitas Indonesia

iii Universitas Indonesia

KATA PENGANTAR
Puji syukur saya panjatkan kepada Allah SWT karena atas berkat dan rahmat-Nya, sehingga
saya dapat menyelesesaikan tesis ini. Penulisan tesis ini dilakukan dalam rangka memenuhi
salah satu syarat unutk memperoleh gelar Spesialis Radiologi pada Fakultas Kedokteran
Universitas Indonesia. Saya menyadari bahwa tanpa bantuan dan bimbingan berbagai pihak
dari masa perkuliahan sampai penulisan tesis ini, akan sulit sekali untuk saya menyelesaikan
tesis ini. Oleh karena itu, saya mengucapkan terima kasih kepada :
1. dr Retno Dwi Astuti, SpRad(K), sebagai pembimbing radiologis yang telah

menyediakan waktu, tenaga dan pikiran untuk mengarahkan saya dalam penyusunan
tesis ini.
2. Dr. dr Amiliana Mardiani Soesanto, SpJP, sebagai pembimbing klinis yang telah
menyediakan waktu, tenaga dan pikiran untuk mengarahkan saya dalam penyusunan
tesis ini.
3. Dr. dr Joedo Prihartono, MPH, sebagai pembimbing statistik yang telah menyediakan
waktu, tenaga dan pikiran untuk mengarahkan saya dalam penyusunan tesis ini.
4. dr Rahmi Afifi, SpRad, sebagai penguji pokja yang telah memberikan arahan dan
masukan yang bermanfaat dalam penyusunan tesis ini.
5. dr Marcel Prasetyo, SpRad, sebagai penguji metodologi yang telah memberikan
arahan dan masukan yang bermanfaat dalam penyusunan tesis ini.
6. dr Vally Wulani, SpRad, sebagai moderator dan pembimbing akademik yang telah
memberi masukan dan bimbingan serta pengalaman yang bermanfaat selama saya
menjalani proses pendidikan.
7. dr Sawitri Darmiati, SpRad(K), sebagai Ketua program studi radiologi yang telah
memberikan memberikan masukan yang bermanfaat dalam penyusunan tesis ini.
8. dr Indrati Suroyo, SpRad(K), sebagai Kepala Departemen Radiologi yang telah
membagi ilmu dan pengalaman yang bermanfaat.
9. Guru-guru saya yang lain di RSUPN Cipto Mangunkusumo, RSPAD Gatot Subroto,
RSUP Fatmawati, RSUP Persahabatan, RS Jantung Harapan Kita, RSAB Harapan
Kita dan RS Kanker Dharmais yang tidak dapat saya sebutkan namanya satu-persatu
yang telah membimbing saya selama menjanai proses pendidikan.
iv Universitas Indonesia

10. Seluruh radiografer yang bertugas di departemen Radiologi RS Jantung Harapan Kita
dan seluruh staf ekokardiografi RSJHK yang telah membantu saya dalam
menyelesaikan tesis ini.
11. Seluruh staf dan karyawan departemen Radiologi RSUPN Cipto Mangunkusumo,
RSPAD Gatot Subroto, RSUP Fatmawati, RSUP Persahabatan, RS Jantung Harapan
Kita, RSAB Harapan Kita dan RS Kanker Dharmais yang telah bekerjasama dan
membantu saya dalam menjalani pendidikan.
12. Orang tua saya, kakak saya Helen, Alice dan Louisa serta Ruth yang tercinta yang
telah memberikan dukungan moral dan doa selama saya menjalani pendidikan.
13. Rekan-rekan sejawat PPDS I Radiologi yang telah memberikan perhatian dan
dukungan serta masukan yang bermanfaat dalam menyelesaikan tesis ini dan selama
saya menjalani pendidikan terutama rekan-rekan satu angkatan Januari 2010.
Akhir kata saya berharap Tuhan Yang Maha Esa berkenan membalas segala kebaikan semua
pihak yang telah membantu dan mendukung saya. Semoga tesis ini dapat membawa manfaat
bagi pengembangan ilmu dan pelayanan masyarakat
Jakarta, 21 Agustus 2013
Hormat saya,
dr Brian Lucas
v Universitas Indonesia

HALAMAN PERNYATAAN PERSETUJUAN PUBLIKASI TUGAS AKHIR UNTUK
KEPENTINGAN AKADEMIS
Sebagai sivitas akademik Universitas Indonesia, saya yang bertanda tangan di bawah ini :
Nama : dr Brian Lucas

NPM : 0906647766
Program Studi : Radiologi
Fakultas : Kedokteran
Jenis karya : Tesis
Demi pengembangan ilmu pengetahuan, menyetujui untuk memberikan kepada Universitas

Indonesia Hak Bebas Royalti Noneksklusif (Non-exclusive Royalty Free Right) atas karya
ilmiah saya yang berjudul :
Uji Sensitivitas dan Spesifisitas Radiografi Toraks dibandingkan Pemeriksaan

Ekokardiografi dalam Mendeteksi Kelainan Katup Mitral pada Pasien dengan
Pembesaran Atrium Kiri
Beserta perangkat yang ada (bila diperlukan). Dengan Hak Bebas Royalti Noneksklusif ini
Universitas Indonesia berhak menyimpan, mengalih media/formatkan, mengelola dalam
bentuk pangkalan data (database), merawat dan mempublikasikan tugas akhir saya tanpa
meminta izin dari saya selama tetap mencantumkan nama saya sebagai penulis/pencipta dan
sebagai pemilik Hak Cipta.
Demikian pernyatan ini saya buat dengan sebenarnya.
Dibuat di : Jakarta
Pada tanggal : 21 Agustus 2013
Yang menyatakan,
(dr Brian Lucas)
vi Universitas Indonesia

ABSTRAK
Nama : Brian Lucas

Program studi : Radiologi
Judul : Uji Sensitivitas dan Spesifisitas Radiografi Toraks Dibandingkan
Pemeriksaan Ekokardiografi dalam Mendeteksi Kelainan Katup
Mitral pada Pasien dengan Pembesaran Atrium Kiri
ABSTRAK
Pendahuluan : Prevalensi penyakit katup jantung telah mengalami penurunan hingga
mencapai 0,5-2 per 100,000 penduduk di negara maju seperti Amerika Serikat saat ini,
namun masih merupakan masalah di negara berkembang. Berbagai penelitian telah dilakukan
selama ini mencoba mencari modalitas radiologi lain selain pemeriksaan ekokardiografi
(baku emas) sebagai modalitas penapisan kelainan katup mitral, namun pemeriksaan yang
ada merupakan pemeriksaan mahal dan ketersediaannya yang masih terbatas.
Tujuan : menghitung nilai sensitivitas, spesifisitas dan predicitve value dari radiografi toraks
proyeksi posteroanterior dibandingkan ekokardiografi dalam mendeteksi kelainan katup
mitral pada pasien dengan pembesaran atrium kiri.
Metode : Penelitian ini merupakan penelitian uji diagnostik cross sectional secara
retrospektif dengan menggunakan data sekunder pasien yang mengalami pembesaran atrium
kiri di Rumah Sakit Jantung Harapan Kita.
Hasil : Tingkat sensitivitas dan spesifisitas radiografi toraks proyeksi posteroanterior
dibandingkan dengan ekokardiografi dalam mendeteksi kelainan katup mitral pada pasien
dengan pembesaran atrium kiri adalah 85,7% dan 43%. Nilai positif predictive value adalah
94,7% dan nilai negatif predictive value adalah 20%.
Kesimpulan : Pemeriksaan radiografi toraks proyeksi posteroanterior dengan pembesaran
atrium kiri dapat digunakan untuk penapisan pada pasien dengan kecurigaan kelainan katup
mitral stadium dini, sedangkan pada stadium lanjut dapat digunakan sebagai pengganti
pemeriksaan ekokardiografi.
Kata kunci : Kelainan katup mitral, stenosis mitral, regurgitasi mitral, ekokardiografi, torak
vii Universitas Indonesia

ABSTRACT
Name : Brian Lucas

Study Program : Radiology
Title :“Sensitivity and Specificity Test of Radiography Thorax Compared to
Echocardiography in Detecting Mitral Valve Diseases in a Patient
with Left Atrium Enlargement”
Abstract
Introduction : Prevalence of valvular heart disease has been decreasing in the past few
decade approximately 0,5-2 over 100.000 population in the country like USA. However this
still be a problem in the developing countries. Many research already done to search an
alternative radiology modality besides echocardiography (gold standard) as a modality for
screening mitral stenosis but the modality is expensive and not well distributed.
Objective : to assess the sensitivity, specificity and predictive value of radiography thorax
posteroanterior projection in patient with enlargement of left atrium to detect mitral valve
diseases compared with echocardiography findings.
Methods : This study is a diagnostic study by cross sectional design with retrospective
approach by using secondary data from patient with enlargement of left atrium in Jantung
Harapan Kita Hospital.
Results : The sensitivity and specificity of radiography thorax posteroanterior projection in
patient with enlargement of left atrium in detecting mitral valve disease compared with
echocardiography is 85,7% and 43%. Positive predictive value is 94,7% and negative
predictive value is 20%.
Conclusions : Radiography thorax posteroanterior projection with enlargement of left atrium
can be used as a screening in patient with mitral valve disease in the early stage, meanwhile
in late stage can be used to replace echocardiography examination.
Key Words : Mitral valve disease, mitral stenosis, mitral regurgitation, echocardiography,
radiography thorax.
viii Universitas Indonesia

Daftar Isi
Halaman Judul ………………………………………………………………………………i
Halaman Pernyataan Orisinalitas …………………………………………………………ii
Halaman Pengesahan ………………………………………………………………………iii
Kata Pengantar ……………………………………………………………………………..iv
Halaman Pernyataan Persetujuan Publikasi Karya Ilmiah Untuk Kepentingan

Akademis ……………………………………..……………………………………………..vi
Abstrak ………………………………………………………………………...…………...vii
Abstract ………………………………………………………………….…………..……..viii
Daftar Isi ………………………………………………………………………..……….….ix
Daftar Lampiran …………………………………………………………...…………...….xi
Daftar Gambar ………………………………………………………………...…………..xii
Daftar Tabel …………………………………………………………………….…...……xiii
Bab 1. Pendahuluan.................................................................................................................1
1.1. Latar belakang…………………………………………………………………………...1

1.2. Rumusan masalah……….................................................................................................2
1.3. Hipotesis…………………………………………………………………...………….….3
1.4. Tujuan penelitian…………………………………………………………....…………..3
1.4.1. Tujuan umum…………………………………………........................……….3
1.4.2. Tujuan khusus……………………………...............…………….……………3
1.4.3. Manfaat penelitian……………………………………………………………..3
Bab 2. Tinjauan Pustaka………………………………..…………………………….…......5
2.1. Definisi……………………………………………………………………………..….….5
2.2. Epidemiologi……………………………………………………………………...……...5
2.3. Anatomi………………………………………………………………………….…….....5
ix Universitas Indonesia

2.4. Patofisiologi……………………………………………………………………....………6
2.5. Manifestasi klinis……………………………………………………………...………...7
2.6. Diagnosis………………………………………………………………………….……...8
2.6.1. Pemeriksaan fisik dan klinis…………………………….……………………8
2.6.2. Elektrokardiografi…………………………….……………………………....8
2.6.3. Ekokardiografi………………………………….………………………..……9
2.7. Pemeriksaan radiologi……………………………………………………...…….....…10
2.7.1. Radiografi konvensional toraks………………………...……………...……10
2.7.2. CT Scan jantung……………………………………………………..………15
2.7.3. MRI jantung………………………………………………………….....……15
2.7.4. Angiografi…………………………………………………………....….……16
2.8. Terapi…………………………………………………………………………….……..16
2.9. Prognosis………………………………………………………………………….…….17
2.10. Kerangka teori…………………..………………………………………………...…..18
2.11. Kerangka konsep…………………………………………………………….….…….19
Bab 3. Metodologi Penelitian………………………………………………………...….….20
3.1. Desain penelitian………………………………………………………………..……...20
3.2. Tempat dan waktu………………………………………………………………..…....20
3.3. Populasi…………………………………………………………………………..….….20
3.4. Sampel………………………………………………………………………..………....20
3.5. Subjek penelitian……………………………………………………………………….21
3.5.1. Kriteria penerimaan…………………………………………………..….….21
3.5.2. Kriteria penolakan…………………………………………………………...21
3.6. Batasan operasional……………………………………………………………..…..…22
3.7. Cara kerja……………………………………………………………………...…….....24
3.8. Alur penelitian…………………………………………………………………....…….25
3.9. Analisis data…………………………………………………………………...…….….26
3.10. Masalah etika…………………………………………………………...……….…….26
3.11. Pendanaan………………………………………………………...…………………...26
Bab 4. Hasil Penelitian………………………………………………………………...……27
x Universitas Indonesia

4.1. Karakteristik subjek penelitian.....................................................................................27
4.2. Hasil evaluasi data penelitian.........................................................................................28
4.3. Analisis data.....................................................................................................................29
Bab 5. Pembahasan................................................................................................................35
Bab 6. Kesimpulan dan saran...............................................................................................39
Daftar Pustaka……………………………………….……………………..……………….40
Lampiran 1 Formulir penelitian ……………..........………………………………..……..43
xi Universitas Indonesia

Daftar Gambar
Gambar 1. Anatomi katup jantung.......................................................................................6
Gambar 2. Pengukuran pembesaran atrium kiri...............................................................11
Gambar 3. Pengukuran hipertensi pulmonal......................................................................11
Gambar 4. Garis kerley B.....................................................................................................12
Gambar 5. Pengukuran arteri pulmonal.............................................................................13
Gambar 6. Pengukuran pembesaran ventrikel kanan.......................................................13
Gambar 7. Distribusi subjek penelitian berdasarkan diagnosis ekokardiografi.............27
xii Universitas Indonesia

Daftar Tabel
Tabel 1. Grade stenosis mitral berdasarkan ekokardiografi...............................................9
Tabel 2. Grade regurgitasi mitral berdasarkan ekokardiografi........................................10
Tabel 3. Sebaran karakteristik subyek penelitian...............................................................26
Tabel 4. Hasil evaluasi kelainan katup mitral berdasarkan radiografi toraks dan
ekokardiografi........................................................................................................................30
Tabel 5. Hasil evaluasi stenosis mitral berdasarkan radiografi toraks dan

ekokardiografi........................................................................................................................29
Tabel 6. Hasil evaluasi hipertensi pulmonal berdasarkan radiografi toraks dan

ekokardiografi........................................................................................................................32
Tabel 7. Hasil evaluasi ventrikel kanan berdasarkan radiografi toraks dan

ekokardiografi........................................................................................................................31
xiii Universitas Indonesia

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
   

          

          
            
           
        
       
       


             
         
        
         
       

           

          


         
        


         
        
        
         
         

          


        

           
         

  
           
          
          
          
         
       

     

          


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          

          

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
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
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        

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
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        
         

        
         

         
         

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
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

          

          
       


            

           

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

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
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            

         
          
         
             


          
          
          

          


            



         
             
          

          


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







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

           


         
         
       
            
           

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       
          
          
            
           




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

          
          
           

           
       
        


             
          


       


          
           



       

           

         

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
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           
            
          
         
           
         

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
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
       
         
        

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
            
           
      

   
           

          

           



          
           
        

         
          
            
             






            
             

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
       

          
           
        
        

         



       
       

          
         
           

              

           
           
          
          
         
        




           
           
         

           
          
         
        

           

      

          

   
          


          

        

 
           



   
    
   


   

   



            
 
           

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
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


              
         
         
 
            
            
            
           
         


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        
           
           
         
              
            
          

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               
             

        

            
         
           

          

          
            
         
        

             
          
            

          
         
           
          
           
              
 
              



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
 
         
         
           
         
           
          
         
            



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
         
          
         


           


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
 
           
         
            
              
             
 

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
        

         

           
  
          

           
           
             



    

          
         

           
           

          



           
           
          
          
           
           
          

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
         


           





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
        

 
        
        
         



          
           

 

          

         
        

          
          


          
         

        
          
           
          
         
          
       
           

          
         
          
        

   

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
        

           
          

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

    

 
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
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
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
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 

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 
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   

  
 
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  
 
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 
 
 


 
 
 
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 
  
  




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 
 
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 
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 
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  
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 
 
 
 
  
 
  
 

 
  

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

          
          
          

         


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








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

        
         

         



         



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   
   
   
   
   
   
   
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
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         

          





         

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

 


 






 




          
         

 
           

 

 
          
         





 

           
          

        


          
              

        
           




          
              
             
 

         
           
            





         
  



          

           
           
            

          


            
        

          
          


           
          
         
         
         
           
         
        
          



 

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  
 

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
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 
  
 
   

 
 



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
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 

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 
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
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
           
            

          
          
            


         


         


          




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
            
         

          

          
       
         
           
          



  
  
  
  
  
  
  
           
           


          

             



            
          


           



  



          
           



           

   
 
 
 
     


     


     









          
         
            
          
       

           



        
           
         
         


   
 
     



     



     








          
         
            

         

          




          
         
          


   
 
 
     


     


     








           
         

            

          
          

            


   
 
 
 
     



     



     









          
           


          

         
             

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

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
           

          
          

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          
            

          

            

           

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
              
          
     
             
           
         
     

            
            
          
           
         


       

         



         
         
        
          
        
           
        

        
          
          

           
         


        

 
              
       
          



           
           


          



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         
            
         
           
         

          
          
            

           
            
         
        

        

         

           
          
         
          
           

         




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

       


        

         
         



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
        



        
         

       
       
           

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
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 


 
              

 
 

 

              
            

 

 


  

 
         






          


             

            


          
        

  
        
          

           




       

         


          

            
        













          
  

            

          





       
































44
Ekokardiografi Toraks
Nama Usia J. Area Gradient

No.
(inisial) (Thn) Kelamin A. V. Katup Rata- Hipertensi A. Hipertensi Kerley V.
MS Diagnosis MS A. Pulmonal
Kiri kanan Mitral Rata Pulmonal Kiri Pulmonal B Kanan
(cm2) (mmHg)
MS berat, MR
1 SA 39 P + + + 0,8 13 + + + + + + +
sedang
TR sedang, PH
2 J 42 P - + - - - + berat - + - - - -
MS berat, MR
3 R 54 P + + - 0,8 14 + ringan-sedang + + + - + -
MS berat, MR
4 A 61 P + + - 0,8 6 + sedang + + + - + -
MS berat, MR
5 MM 48 P + + + 0,9 15 + sedang - + - - + +
6 DN 40 P - - - - - - Normal - + - - - -
MR ringan, AR
7 AN 19 P - + - - - - ringan + + + - - -
8 M 51 P + + + 1,2 3 - MS sedang + + + - + +
9 M 40 P + + - 0,8 11 + MS berat + + + - + -
10 B 52 L + + - 0,5 13 + MS berat + + + + - -
MS berat, MR
11 SA 46 P + + - 0,7 7 + sedang-berat + + + - + -
12 E 50 P + + - 0,9 18 + MS Berat + + + - + -
MS Ringan-
sedang, MR
13 S 46 P + + - 1,4 12 - berat + + + - + -
Universitas Indonesia
45
14 T 45 P + + - 0,5 20 + MS berat + + + - + -
15 FA 31 P + + + 0,7 12 + MS berat + + + - - +
16 DA 40 P + + - 0,4 14 + MS berat + + + + + -
17 S 57 P + + - 0,5 13 + MS berat + + + + + +
18 A 36 P - - - 3,5 - - MR ringan + + + - + -
19 S 44 L + + - 0,8 13 - MS berat + + + - - +
20 DH 29 P + + - 0,8 14 - MS berat + + + - - -
PDA, MR
21 SR 35 L - + - - - - ringan + + + + + -
22 SR 48 P - + - - - - MR berat - + - - - -
23 E 56 L - + - - - + MR berat + + + - - -
MS berat, MR
24 S 63 P + + - 0,9 8 - sedang + + + - - -
MS berat, MR
25 W 30 P + + - 0,6 6 + sedang + + + - + -
MS berat, MR
+
26 IB 48 P + + - 0,8 15 - ringan + + - + -
27 N 55 P + + + 0,3 16 - MS berat + + + - - +
MR berat, MS
28 AY 77 L + + + 1,3 10 + sedang + + + - + -
MS berat, MR
29 WR 29 P + + + 0,7 9 + berat + + + + + +
MR ringan
30 C 52 L - + - - - + sedang - + - + - -
31 WSL 22 P - + - 1,9 7 + MR berat + + + - + -
46
32 S 49 L - + - - - + MR sedang - + - - + -
MR berat, MS
33 R 24 P + + + 1,4 9 + ringan-sedang + + + - + +
MS berat, MR
34 NWS 19 P + + - 0,8 16 + ringan-sedang + + + + + -
35 NJ 27 P + + - 0,9 10 - MS Berat + + + - - -
36 DS 25 P - - + - - + ASD + + + - - +
37 A 70 L + + - 0,4 8 + MS berat + + + - - -
38 A 21 P - - - - - - MR ringan + + + - - +
39 AK 58 L - + - - - + MR berat + + + - - -
MS berat, MR
40 LP 46 P + + - 0,7 14 + ringan-sedang + + + + + -
MS sedang-
berat, MR
41 NSB 50 P + + - 0,6 5 + ringan + + + - - -
42 S 33 P + + - 1,2 7 + MS sedang + + + - - -
MS sedang, MR
43 RN 55 L + + - 1,2 7 + sedang + + + - - -
MS sedang, MR
44 W 52 L + + - 1,3 5 - ringan + + + - - -
45 MS 27 L - - - - - + VSD - + - - - -
46 E 43 P + + - 0,6 15 + MS berat + + + + + -
47 M 67 P + + - 1,2 7 + MS sedang + + + + - -
48 S 32 P + + - 1,9 9 - MR sedang- + + + - + -
berat, MS
47
ringan
MS berat, MR
49 N 35 P + + - 0,9 16 + ringan + + + - + -
MS berat, MR
+
50 L 36 P + + + 0,9 11 + ringan + + - + +
MR sedang-
berat, MS
51 RN 25 P + + - 1,7 24 + ringan + + + - + -
52 S 41 L - + - - - - MR berat - + - - - +
53 TY 26 P - - - - - + ASD + + + - + -
MR berat, MS
54 MFP 38 P + + - 1,2 7 - sedang + + + - + -
MS sedang-
berat, MR
55 K 39 L + + - 1,1 8 - ringan + + + - + -
56 S 55 P - + - - - + MR berat + + + - + -
57 SY 55 L - + - - - + MR berat + + + - - -
58 Y 55 P - + + - - + MR ringan + + + - - -
59 FH 44 L - + - - - - MR berat + + + - + -
60 RH 24 P - + - - - - MR berat - + - - - -
61 ES 46 L - + - - - + MR berat + + + - - -
62 NS 46 P - + - - - - MR berat + + + - - -
63 WT 55 L - + - - - - MR sedang - + - - - -
MS berat, MR
64 R 47 L + + - 0,8 13 + sedang + + + - + -
48
65 H 34 P + + - 0,9 11 + MS berat + + + - + -
AS berat, MR
+
66 RA 45 L - - - - - - ringan - - - - -
67 OGT 41 P - + - - - + MR berat + + + - + -
68 H 55 L - - - - - + MR berat + + + - - +
69 AP 22 L - + - - - + MR berat + + + - - -
70 FAM 30 L + + - 0,5 10 - MS berat + + + - + -
MR sedang-
71 TGF 70 P - + - - - - berat + + + - - -
MS berat, MR
72 S 23 P + + + 0,7 6 + berat + + + - + +
73 F 31 P - + - - - - MR berat - + - - - -
74 Y 52 L - - - - - + MR berat + + + - - -
75 B 33 L - + - - - + MR berat - + - - - -
76 L 49 L - - - - - + MR ringan + + + - - -
77 N 27 P + + + 0,3 16 + MS berat + + + - - +
78 YH 39 L + + - 0,4 12 + MS berat + + + + + -
MS sedang-
berat, MR
79 E 69 P + + - 0,6 12 + sedang + + + - + -
80 IY 40 L - + - - - - MR berat - + - - - -
81 NR 36 P - + - - - - MR berat + + + - - -
82 S 57 L - + - - - - MR berat - + - - - -
83 R 46 L + + - 0,9 20 + + + + - - -
MS berat, MR
49
sedang
MS ringan-
sedang, MR
84 E 53 P + + - 1,6 4,5 + ringan + + + - - -
85 SF 55 L - + - - - + MR berat + + + - - -
86 UR 48 L - + - - - + MR berat + + + - - -
MS berat, MR
87 NK 30 P + + - 0,4 16 + sedang + + + - + -
88 A 37 P - - + - - + ASD + + + - + -
89 NN 34 P - - + - - - ASD + + + - + +
MR sedang, MS
+
90 LS 41 P + + - 1,6 8 - ringan + + - + -
MS berat, MR
91 ME 62 L + + - 0,6 19 + sedang + + + - + -
50

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Uji Sensitivitas dan Spesifisitas Radiografi Toraks dibandingkan Pemeriksaan

Ekokardiografi dalam Mendeteksi Kelainan Katup Mitral pada Pasien dengan

PROGRAM PENDIDIKAN DOKTER SPESIALIS I RADIOLOGI

Uji sensitivitas…, Brian Lucas, FK UI, 2013

dirujuk telah saya nyatakan dengan benar

Nama : Brian Lucas

Tanggal : 21 Agustus 2013

Uji sensitivitas…, Brian Lucas, FK UI, 2013

Uji sensitivitas…, Brian Lucas, FK UI, 2013

1. dr Retno Dwi Astuti, SpRad(K), sebagai pembimbing radiologis yang telah

Uji sensitivitas…, Brian Lucas, FK UI, 2013

Jakarta, 21 Agustus 2013

Uji sensitivitas…, Brian Lucas, FK UI, 2013

Nama : dr Brian Lucas

Demi pengembangan ilmu pengetahuan, menyetujui untuk memberikan kepada Universitas

Uji Sensitivitas dan Spesifisitas Radiografi Toraks dibandingkan Pemeriksaan

Demikian pernyatan ini saya buat dengan sebenarnya.

Pada tanggal : 21 Agustus 2013

(dr Brian Lucas)

Uji sensitivitas…, Brian Lucas, FK UI, 2013

Nama : Brian Lucas

vii Universitas Indonesia

Uji sensitivitas…, Brian Lucas, FK UI, 2013

Name : Brian Lucas

viii Universitas Indonesia

Uji sensitivitas…, Brian Lucas, FK UI, 2013

Halaman Judul ………………………………………………………………………………i

Halaman Pernyataan Orisinalitas …………………………………………………………ii

Halaman Pengesahan ………………………………………………………………………iii

Kata Pengantar ……………………………………………………………………………..iv

Halaman Pernyataan Persetujuan Publikasi Karya Ilmiah Untuk Kepentingan

Daftar Isi ………………………………………………………………………..……….….ix

Daftar Lampiran …………………………………………………………...…………...….xi

Daftar Gambar ………………………………………………………………...…………..xii

Daftar Tabel …………………………………………………………………….…...……xiii

1.1. Latar belakang…………………………………………………………………………...1

Uji sensitivitas…, Brian Lucas, FK UI, 2013

3.9. Analisis data…………………………………………………………………...…….….26

3.10. Masalah etika…………………………………………………………...……….…….26

Bab 4. Hasil Penelitian………………………………………………………………...……27

Uji sensitivitas…, Brian Lucas, FK UI, 2013

4.2. Hasil evaluasi data penelitian.........................................................................................28

4.3. Analisis data.....................................................................................................................29

Bab 6. Kesimpulan dan saran...............................................................................................39

Lampiran 1 Formulir penelitian ……………..........………………………………..……..43

Uji sensitivitas…, Brian Lucas, FK UI, 2013

Gambar 1. Anatomi katup jantung.......................................................................................6

Gambar 2. Pengukuran pembesaran atrium kiri...............................................................11

Gambar 3. Pengukuran hipertensi pulmonal......................................................................11

Gambar 4. Garis kerley B.....................................................................................................12

Gambar 5. Pengukuran arteri pulmonal.............................................................................13

Gambar 6. Pengukuran pembesaran ventrikel kanan.......................................................13

Gambar 7. Distribusi subjek penelitian berdasarkan diagnosis ekokardiografi.............27

xii Universitas Indonesia

Uji sensitivitas…, Brian Lucas, FK UI, 2013

Tabel 1. Grade stenosis mitral berdasarkan ekokardiografi...............................................9

Tabel 2. Grade regurgitasi mitral berdasarkan ekokardiografi........................................10

Tabel 3. Sebaran karakteristik subyek penelitian...............................................................26

Tabel 5. Hasil evaluasi stenosis mitral berdasarkan radiografi toraks dan

Tabel 6. Hasil evaluasi hipertensi pulmonal berdasarkan radiografi toraks dan

Tabel 7. Hasil evaluasi ventrikel kanan berdasarkan radiografi toraks dan

xiii Universitas Indonesia

Uji sensitivitas…, Brian Lucas, FK UI, 2013

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