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"Latar Belakang: Dalam diagnosis varises vena tungkai bawah (VVTB), venous clinical severity score (VCSS) merupakan alat bantu diagnosis VVTB yang praktis, cepat, dan dapat dikerjakan oleh semua tenaga kesehatan termasuk perawat. Hingga saat ini belum ada peneliti yang melakukan validasi eksterna penilaian VCSS yang dikerjakan oleh perawat di Indonesia.Tujuan: Mengetahui tingkat ketepatan metode skor VCSS oleh perawat dibandingkan dengan komponen klinis (C) klasifikasi clinical-etiology-anatomy-pathophysiology (CEAP) oleh dokter spesialis bedah vaskular.Metode: Studi cross-sectional ini mengikutsertakan 63 orang perawat instalasi bedah pusat RS Dr. Cipto Mangunkusumo tanpa varises sebelum menjadi perawat sebagai sampel yang diambil secara consecutive Penilaian VCSS dilakukan dengan komponen klinis klasifikasi CEAP sebagai pembanding. Variabel dianalisis dengan uji Chi-square, dilanjutkan dengan uji nilai sensitivitas, spesifisitas, nilai duga positif (NDP), nilai duga negatif (NDN), likelihood ratio dan akurasi skor diagnostik, termasuk analisis uji diagnostik menggunakan indeks Youden.Hasil: Prevalensi VVTB pada studi ini berdasarkan skor VCSS adalah 9,5%. Korelasi antara klasifikasi CEAP dan VCSS ditemukan bermakna (p<0,05). Derajat VVTB antara klasifikasi CEAP dan VCSS berhubungan secara signifikan (p <0,05). Pada cut-offVCSS 2 didapatkan nilai sensitivitas 66,67%, spesifisitas 66,67 %, NDP 32,0%, NDN 89,47%, likelihood ratio (+) sebesar 2,00, likelihood ratio (-) sebesar 0,50, dan akurasi 66,67%.Kesimpulan: Skor VCSS memiliki akurasi lemah terhadap komponen klinis (C) klasifikasi CEAP untuk menegakkan diagnosis VVTB.

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Background: In the diagnosis of lower leg varicose veins (LLVV), the venous clinical severity score (VCSS) is practical, fast, and can be done by all health workers including nurses. Until now there has been no researcher who has conducted external validation of the VCSS assessment carried out by nurses in Indonesia.

Aim: To determine the accuracy of the VCSS scoring method by nurses compared to clinical component (C) of the clinical-etiology-anatomy-pathophysiology (CEAP) classification by vascular surgeons.

Method: This cross-sectional study included 63 nurses at the central surgical installation of Cipto Mangunkusumo Hospital without varicose veins before becoming a nurse as a consecutive sample. The VCSS assessment was carried out with the clinical component of CEAP classification as a comparison. Variables were analyzed by the Chi-square test. Followed by testing the value of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio, and accuracy of diagnostic scores, along with the ROC analysis using Youden Index.

Results and Discussion: The prevalence of LLVV in this study is 9,5%. Bivariate analysis of CEAP and VCSS has a significant correlation (p <0,05). The degree of LLVV with CEAP and VCSS is related significantly (p <0,05). With VCSS cut off at scores of 2, the sensitivity is 66.67%, the specificity is 66.67%, the PPV is 32,0%, the NPV is 89.47%, the positive and negative likelihood ratio are 2.00 and 0.50, and the accuracy value is 66.67%.

Conclusion: The VCSS score has weak level of accuracy against the clinical component (C)  of CEAP classification for diagnosing VVTB."

"American Venous Forum Commitee dari tahun 2000 ndash; 2011 terus mengembangkan sistem skoring penilaian derajat keparahan penyakit vena yang praktis bernama Venous Clinical Severity Score VCSS , namun di Indonesia, instrument VCSS hingga saat ini belum pernah dilakukan validasi. Penelitian ini adalah uji diagnostik skoring VCSS dengan membandingkan pemeriksaan penyakit vena menggunakan skoring VCSS oleh dokter umum dibandingkan dengan pemeriksaan klinis CEAP oleh dokter spesalis vaskuler sebagai baku emasnya. Penelitian dilakukan di perusahaan garmen di Jakarta Utara pada bulan Oktober dengan nilai sensivitas 87,5 , spesifitas 96,3 , nilai duga positif 83,3 dan nilai duga negatif 97,3 . Dari Hasil analisis kurva ROC nilai Area Under the Curve AUC sebesar 94,9 sangat baik. Faktor risiko paling dominan terhadap kejadian IVK pada pekerja wanita dengan posisi kerja berdiri adalah masa kerja lebih dari 1 tahun dengan.

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The American Venous Forum Commitee from 2000 2011 continues to develop a practice scoring system on the severity of venous disease called Venous Clinical Severity Score VCSS , but in Indonesia, this VCSS instrument, until now has never been validated. This study is a VCSS scoring diagnostic test which compere the examination CVI using VCSS by general practitioner and using clinical class of CEAP by vascular specialist as gold standard. Based on the research, the VVTB diagnostic test by using VCSS score was 87.5 sensitivity, 96.3 specificity, 83.3 positive predictive value and 97.3 negative predictive value. From ROC curve analysis, the value of Area Under the Curve AUC is 94.9 which means very good. The most dominant risk factors for the occurrence of CVI in female workers with standing positions were more than 1 year with p "

"Pada tahun 2010 American Venous Forum mengembangkan sebuah sistem skoring Venous Clinical Severity Score (VCSS) untuk menilai tingkat keparahan Insufisiensi Vena Kronik, dimana system ini dikatakan lebih lengkap daripada system CEAP. Tetapi validasi VCSS terhadap uji obyektif masih kurang. Tujuan Penelitian ini adalah untuk menguji VCSS terhadap refluks dan diameter vena tungkai berdasarkan ultrasonografi. Penelitian ini merupakan suatu uji diagnostik potong lintang pada pekerja wanita dengan posisi kerja berdiri sebnyak 114 orang (228 tungkai). Dilakukan penilaian VCSS dan pemeriksaan USG pada semua subjek. Hubungan antara VCSS dengan refluks dan diameter vena tungkai dianalisis menggunakan odd rasio dengan interval kepercayaan 95%. Dari 228 tungkai yang diperiksa didapatkan skor VCSS 0-3 sebanyak 18,4%, skor ≥4sebanyak 81,6%. Refluks didapatkan pada 21,9% tungkai. Terdapat hubungan yang signifikan antara VCSS dengan refluks pada vena tungkai. Sedangkan diameter vena safena magna antara 2,1-12,2mm, vena femoral 7,1-17mm, vena popliteal 3-11,4 dan vena safena parva 1,7-7mm. Ketika VCSS dihubungkan dengan diameter vena, didapatkan hubungan yang signifikan. Sensistivitas VCSS dibandingkan dengan refluks berdasarkan USG didapatkan 78%, spesivitas 98,31%, nilai prediksi positif 92,86% dan nilai prediksi negatif 93,86%. Dari hasil penelitian ini disimpulkan skoring VCSS dapat dipakai sebagi metode untuk menilai insufisiensi vena kronik. Meskipun VCSS dirancang untuk menilai keparahan penyakit vena kronis,  VCSS dapat juga dipaki untuk melakukan skrining karena menujukkan hubungan yang baik dengan refluks dan diameter vena tungkai berdasarkan USG.

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In 2010 the American Venous Forum developed a scoring system for the Venous Clinical Severity Score (VCSS) to assess the severity of chronic venous insufficiency, where the system is said to be more complete than the CEAP system. But the VCSS validation of the objective test is still lacking. The aim of this study was to test VCSS for reflux and diameter of leg veins based on ultrasonography. This study is a cross-sectional diagnostic test on female workers with a working position standing at 114 people (228 limbs). VCSS assessment and ultrasound examination were performed on all subjects. The relationship between VCSS and reflux and limb vein diameter was analyzed using odds ratios with a 95% confidence interval. From the 228 limbs examined, the VCSS score of 0-3 was 18.4%, the score ≥4 was 81.6%. Reflux is obtained at 21.9% of the legs. There is a significant relationship between VCSS and reflux in the leg veins. Whereas the diameter of the safena magna vein is between 2.1-12.2mm, 7.1-17mm femoral vein, popliteal vein 3-11.4 and safena parva vein 1.7-7mm. When VCSS is associated with vein diameter, a significant relationship is obtained. The sensitivity of VCSS compared with reflux based on USG was 78%, the specificity was 98.31%, the positive predictive value was 92.86% and the negative predictive value was 93.86%. From the results of this study concluded VCSS scoring can be used as a method to assess chronic venous insufficiency. Although VCSS is designed to assess the severity of chronic venous disease, VCSS can also be cited for screening because it shows a good relationship with reflux and diameter of leg veins based on ultrasound.

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"Efektifitas EVLA terhadap diameter vena saphena magna yang besar masih banyak diperdebatkan, karena diameter vena saphena magna yang besar memiliki angka oklusi yang lebih rendah pasca EVLA dan diperkirakan mempengaruhi nilai r-VCSS. Desain penelitian ini adalah potong lintang pasien insufiensi vena kronik pada vena saphena magna yang lakukan EVLA di Rumah Sakit Cipto Mangunkusumo dan rumah sakit jejaring dari Juli 2023 – Desember 2023. 37 tungkai dari 34 pasien yang dilakukan EVLA 1470 nm dengan tip radial. Dilakukan pengukuran diameter vena saphena magna dengan usg doppler pada 4 segmen (3 femoral, 1 kruris) dan dibagi berdasarkan nilai potong, dan juga dilakukan penilaian r-VCSS pre EVLA. 1 minggu pasca EVLA dilakukan penilaian oklusi dari vena saphena magna dengan usg doppler dan nilai r-VCSS. Analisis data menggunakan SPSS versi 25.0 secara bivariat dan multivariat. 5 tungkai (13,5%) mengalami gagal oklusi 1 minggu pasca EVLA. Semua kegagalan oklusi pada segmen 1/3 proksimal femoral (diameter >10 mm) (P<0,05). Tidak ada perbedaan bermakna antara angka oklusi dengan nilai r-VCSS, baik pre dan post EVLA (P=0,490 dan P=0,102). Perbedaan diameter sesuai nilai potong tidak mempengaruhi nilai r-VCSS post tindakan. Diameter vena pre-EVLA mempengaruhi keberhasilan oklusi pasca-EVLA. Angka oklusi vena saphena magna tidak mempengaruhi nilai r-VCSS pasca EVLA.

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The effectiveness of EVLA on large saphenous vein diameter is still widely debated, because large saphenous vein diameter has a lower occlusion rate after EVLA and can affect the r-VCSS value. The design of this study was a cross-sectional of patients with chronic venous insufficiency in the great saphenous vein who underwent EVLA at Cipto Mangunkusumo Hospital and a network teaching hospitals from July 2023 – December 2023. 37 extremity from 34 patients underwent 1470 nm EVLA with a radial tip. The diameter of the great saphenous vein was measured using Doppler ultrasound in 4 segments (3 femoral, 1 cruris) and divided based on the cutoff value, and pre-EVLA r-VCSS was also assessed. 1 week after EVLA, the occlusion of the great saphenous vein was assessed using Doppler ultrasound and r-VCSS values. Data analysis used SPSS version 25.0 bivariate and multivariate. cases (13.5%) failed occlusion 1 week post EVLA. All occlusion failure occurred at the 1/3 proximal of the femoral segment (diameter >10 mm) (P<0.05). There was no significant difference between occlusion rates with r-VCSS, pre and post EVLA (P=0.490 and P=0.102). The difference in diameter according to the cut value does not affect the r-VCSS after the procedure. Pre-EVLA vein diameter influences the success of post-EVLA occlusion. The degree of occlusion of the great saphenous vein does not affect the r-VCSS after EVLA."

"Introduction: In 2010, the American Venous Forum developed a Venous Clinical Severity Score (VCSS) scoring system to assess the severity of Chronic Venous Insufficiency (CVI), where this system was said to be more comprehensive than the CEAP system. However, VCSS validation was still lacking. The purpose of this study was to examine VCSS for reflux and leg vein diameter based on ultrasonography. Method: This study was a cross-sectional diagnostic test on women workers with standing work positions of 114 people (228 limbs) in Jakarta. VCSS assessment and ultrasound examinations were carried out on all subjects. The relationship between VCSS with reflux and leg vein diameter was analyzed using an odds ratio with a 95% confidence interval. Results: From 228 examined limbs, the VCSS score of 0-3 was 18.4%, and the score of ≥4 was 81.6%. Reflux was found in 21.9% of the limbs. There was a significant relationship between VCSS and reflux in leg veins. The diameter of the great saphenous vein was between 2.1-12.2 mm, the femoral vein was 7.1-17 mm, the popliteal vein as 3-11.4, and the small saphenous vein was 1.7-7mm. When VCSS was analyzed for association with venous diameter, a significant relationship was found. VCSS sensitivity compared with reflux based on USG was 78%, specificity was 98.31%, positive predictive value was 92.86%, and the negative predictive value was 93.86%.Conclusion: From the results of this study, it was concluded that the VCSS score could be used as a method for assessing chronic venous insufficiency. Although VCSS is was to assess the severity of the chronic venous disease, VCSS can also be used for screening because it shows a good relationship with the reflux and venous diameter of the limbs based on ultrasound."

"Kejadian varises vena banyak terjadi pada profesi perawat. Salah satu faktor penyebabnya adalah akibat berdiri lama. Saat berdiri lama terjadi peningkatan tekanan vena dan disfungsi katup-katup vena yang dapat menimbulkan varises vena. Penelitian ini merupakan penelitian cross-sectional yang melibatkan 92 perawat poliklinik sebagai responden. Instrumen yang digunakan adalah kuesioner yang dimodifikasi dari kuesioner penelitian Tuchsen (2005) serta dilakukan pemeriksaan varises vena dengan Venous Clinical Severity Score (VCSS). Hasil penelitian menunjukkan bahwa 70.7% responden menunjukkan aktivitas berdiri lama dan 72.8% responden mengalami varises vena. Hasil uji chi-square menunjukkan adanya hubungan antara berdiri lama dengan kejadian varises vena dengan p value = 0.001 (OR= 9.051). Deteksi dini varises vena pada perawat perlu dilakukan untuk menekan peningkatan prevalensi varises vena.

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Incidence of varicose veins often occurs on outpatient nurse. Prolonged standing at work is associated with a high prevalence of varicose veins. In the standing position, the venous and capillary pressures increases and damages function of venous valves can leads to incidence of varicose veins. This study was a cross-sectional study that used 92 outpatient nurses for the sample. The instrument of this research was a questionnaire modified from a Tuchsen’s questionnaire (2005) and lower extremity examination using Venous Clinical Severity Score (VCSS).

The result shows that 70.7% of respondents indicated a prolonged standing activity and 72.8% of respondents experienced varicose veins on the lower limbs. The results of chi-square test shows the relationship between prolonged standing and the incidence of varicose veins on the lower limbs with the p value = 0.001 (OR = 9,051). Early detection varicose veins on nurses needs to be done to decrease prevalence of varicose veins."

"ABSTRAKBatasan obyektif dalam menentukan derajat luka ringan dan sedang diperlukan karena Kitab Undang-undang Hukum Pidana (KUHP) tidak menjelaskan deskripsi luka ringan dan sedang, ancaman hukuman bagi tersangka sangat bergantung pada derajat luka yang dialami korban, dan tidak ada metode diagnostik obyektif yang digunakan hingga kini. Khusus untuk kasus penganiayaan dengan temuan memar dan luka lecet, jumlah luka mungkin dapat digunakan sebagai batasan obyektif tersebut karena korban dengan 3 memar pasti mengalami hambatan yang lebih ringan dibandingkan korban dengan 50 memar. Penelitian ini menguji jumlah luka terhadap Trauma and Injury Severity Score (TRISS) dan opini dokter forensik sebagai nilai acuan karena telah teruji dalam penentuan derajat luka sesuai hukum Indonesia. Peneliti mengambil data dari Visum et Repertum kasus penganiayaan Januari 2014 ? Desember 2014 RSCM berupa jumlah luka dan data lain yang diperlukan untuk penentuan derajat luka dengan TRISS kemudian menentukan titik potong (cut-off) luka sedang terbaik dengan ROC berdasarkan data tersebut. Hasil penelitian ini tidak dapat dianalisis karena tidak ada sampel yang termasuk ke dalam luka sedang melalui perhitungan TRISS. Walaupun begitu, jika nilai acuan yang digunakan opini dokter forensik, ditemukan AUC sebesar 90,6% (IK 95%: 75,3% -100%). Titik potong terbaik adalah 12 luka dengan sensitivitas 66,7%, spesifisitas 93,4%, NDP 16,7%, NDN 99,3%, RKP 1007%, dan RKN 35,7% pada prevalensi 3/154. Kesimpulan penelitian ini adalah masih belum diketahui apakah jumlah luka dapat digunakan sebagai batasan obyektif untuk menentukan luka ringan dan sedang pada kasus penganiayaan dengan temuan hanya memar dan/atau luka lecet karena TRISS tidak dapat mendeteksi luka sedang pada populasi sampel.

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ABSTRAKObjective diagnostic tool to determine minor and moderate injuries is necessitate since Indonesian Criminal Code does not give clear descriptions of mild and moderate injuries, severity of injury is the main determinant factor in determining the charges for the assailant, and no objective diagnostic tool currently in use. In cases with only bruises and/or abrasions findings, we propose that quantity of injuries might be used as a diagnostic tool since victim with 3 bruises will experience milder disturbance compared to victim with 50 bruises. The research is diagnostic test which determine whether or not quantity of injuries can be used as a diagnostic tool in those cases with Trauma and Injury Severity Score (TRISS) as the reference value. TRISS was chosen since it?s the only objective method that had been tested to determine severity of injury according to Indonesian Criminal Code. Quantity of injury and other data necessitate to determine severity of injury with TRISS were acquired from Visa et Reperta of assault cases in January 2014 ? December 2014 in RSCM. From the data, we seek the most appropriate cut-off for moderate injury statistically. The results could not be analyzed since there was no moderate injury in the samples according to TRISS. However, if forensic specialists? opinion was used as reference value, the most appropriate cut-off of moderate injury would be 12 injuries with AUC 90,6% (CI 95%: 75,3% - 100%), 66,7% sensitivity, 93,4% specificity, 16,7% PPV, 99,3% NPV, 1007% PLR, and 35,7% NLR in a population with 3/154 prevalence. The conclusion of the research is whether quantity of injuries could be used as a valid diagnostic tool to determine minor and moderate injury in assault cases with only bruises and/or abrasions findings remains unknown since TRISS could not detect moderate injuries in samples? population."

"ABSTRAK Latar belakang Tindakan ablasi endovenous untuk varises tungkai di Indonesia mulai dikerjakan tahun 2010 EVLT dikerjakan di RSCM tahun 2013 dan MOCA dikerjakan di RSUP Fatmawati tahun 2014 Belum ada evaluasi terhadap rekanalisasi pasca tindakan MOCA dan EVLT di Indonesia Metode Studi ini merupakan penelitian deskriptif analitik dengan desain cross sectional Subjek pasca MOCA atau EVLT dengan rentang waktu 3 18 bulan pasca tindakan diwawancara dan dilakukan pemeriksaan USG vaskular pada tungkai yang dioperasi untuk menilai rekanalisasi Data sekunder praoperasi diambil dari rekam medis Dicari karakteristik klinis subjek membandingkan kecenderungan rekanalisasi pasca tindakan MOCA dan EVLT dicari hubungan antara karakteristik klinis subjek dengan kejadian rekanalisasi Data diolah dengan SPSS ver 20 0 Hasil Didapatkan 43 sampel tungkai terdiri dari 24 tungkai pasca MOCA dan 19 tungkai pasca EVLT Karakteristik subjek MOCA terbanyak usia 7 mm 13 19 tungkai Pada MOCA rekanalisasi total didapatkan 2 24 dan partial 8 24 tungkai sedangkan pada EVLT rekanalisasi total 1 19 dan partial 3 19 tungkai Hubungan antara karakteristik klinis subjek dengan kejadian rekanalisasi p 0 05 Kesimpulan Kecenderungan rekanalisasi MOCA lebih tinggi dibandingkan EVLT Tidak ada hubungan bermakna antara karakteristik klinis subjek dengan kejadian rekanalisasi secara statistik namun diameter terbesar VSM 7 mm sebelum operasi secara proporsional lebih tinggi MOCA 3 4 tungkai dibandingkan EVLT 3 13 tungkai ABSTRACT Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities ;Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities ;Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities "

"Latar belakang: Pasien dengan tumor muskuloskeletal (MSK) ganas menunjukkan insidens deep vein thrombosis (DVT) bervariasi. USG Doppler berwarna merupakan modalitas terpilih untuk evaluasi DVT. Tujuan: Menilai hubungan trombus, kecepatan aliran, dan ketebalan dinding vena pada USG Doppler berwarna vena profunda ekstremitas bawah pada pasien dengan tumor primer MSK ganas. Metode: Penelitian ini menggunakan data primer dari pemeriksaan USG Doppler berwarna vena profunda ekstremitas bawah, yaitu trombus, ketebalan dinding vena, dan kecepatan aliran vena, serta data sekunder, yaitu ukuran tumor dari magnetic resonance imaging (MRI) atau computed tomography >(CT) scan dan durasi gejala tumor dari rekam medis. Penelitian dilakukan di Departemen Radiologi dan Poliklinik Orthopaedi dan Traumatologi Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPNCM) bulan Agustus 2020 hingga Maret 2022. Hasil: Terdapat 10% insidens trombus pada sistem vena profunda ekstremitas bawah pada 30 subyek dengan tumor primer MSK ganas. Subyek dengan trombus cenderung memiliki volume tumor lebih besar dibandingkan tanpa trombus, namun secara statistik tidak bermakna. Kesimpulan: Dimensi dan volume tumor pada subyek dengan trombus cenderung lebih besar dibandingkan tanpa trombus. Pada penderita tumor MSK ganas, dapat ditemukan gambaran klinis dan laboratoris yang menyerupai DVT namun belum tentu didapatkan trombus, sehingga USG Doppler berwarna penting untuk membedakan ada tidaknya DVT.

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Background: Patients with malignant musculoskeletal (MSK) tumors show variable incidence of deep vein thrombosis (DVT). Color Doppler ultrasound (CDUS) is the modality of choice for DVT evaluation.

Objective: To assess the relationship of thrombus, flow velocity, and venous wall thickness on CDUS of lower extremities deep veins in patients with primary malignant MSK tumors.

Methods: Primary data from CDUS of lower extremities deep vein, including thrombus, venous wall thickness, and venous flow velocity. Tumor size was taken from magnetic resonance imaging (MRI) or computed tomography (CT) scans. Duration of tumor symptoms was taken from medical records. The study was conducted at the Department of Radiology and the Orthopaedi and Traumatology Polyclinic of the Cipto Mangunkusumo National General Hospital (RSUPNCM) from August 2020 to March 2022.

Results: There was 10% incidence of thrombus in 30 subjects. Subjects with thrombus tended to have larger tumor volume but it was not statistically significant.

Conclusion: Tumor dimensions and volume in subjects with thrombus tend to be larger than those without thrombus. In patients with malignant MSK tumors, clinical and laboratory features that resemble DVT can be found, but not necessarily a thrombus, therefore CDUS is important for distinguishing the presence or absence of DVT."

"Latar Belakang: Malformasi vaskular terjadi pada 1-1.5% populasi, dengan 40-60% kasus anomali terjadi pada regio kepala dan leher karena anatomi vaskularnya yang kompleks. USG Doppler merupakan modalitas diagnostik pertama untuk menangani pasien dengan malformasi vaskular karena biayanya yang rendah, merupakan produk teknologi non-radiasi, serta kemampuannya untuk mengidentifikasi ciri-ciri aliran lesi. Studi ini ditujukan untuk menilai kesesuaian antara temuan klinis dengan temuan ultrasonografi pada pasien dengan malformasi venolimfatik, vena, dan limfatik. Metode: Desain studi ini adalah potong lintang, dengan meggunakan data sekunder di Rumah Sakit Cipto Mangunkusumo dari Januari 2017 hingga Desember 2022. Didapatkan sebanyak 64 subyek dengan kriteria inklusi berupa tersedianya data lengkap berupa kulit kebiruan dan kompresibel pada temuan klinis serta aliran dan kompresibel pada temuan USG Doppler. Analisis data menggunakan perhitungan Kappa Cohen. Hasil: Pada analisis kesesuaian antara temuan klinis warna kulit kebiruan dan komponen low-flow pada USG Doppler didapatkan besar nilai Kappa kesesuaian kuat (K = 0.664) yang bermakna (p = 0.000). Pada analisis kesesuaian temuan klinis kompresibel pada klini s dan kompresiebel pada USG didapatkan hasil measure of agreement Kappa kesesuaian sangat kuat (K = 1.000) yang bermakna (p = 0.000). Simpulan: Terdapat kesesuaian kuat yang bermakna antara temuan klinis berupa warna kulit kebiruan dengan komponen vena dan temuan klinis berupa tidak ada perubahan warna kulit dengan komponen limfatik pada malformasi venolimfatik. Terdapat kesesuaian sangat kuat yang bermakna antara ada tidaknya tanda kompresibel pada temuan klinis dengan ada tidaknya tanda kompresibel pada temuan USG pada malformasi venolimfatik.

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Background: Vascular malformations occur in 1-1.5% of the population, with 40-60% of cases of anomaly occurring in the head and neck region due to their complex vascular anatomy. Doppler ultrasound is the first diagnostic modality for treating patients with vascular malformations due to its low cost, non-radiation technology, and ability to identify flow characteristics of the lesion. This study aimed to assess the concordance between clinical findings and ultrasound findings in patients with venolymphatic, venous, and lymphatic malformations.

Methods: The design of this study was cross-sectional, using secondary data at Cipto Mangunkusumo Hospital from January 2017 to December 2022. A total of 64 subjects were selected with inclusion criteria in the form of the availability of complete data in the form of bluish and compressible sign on clinical findings as well as flow and compressibility sign on Doppler ultrasound findings. Data were analyzed using Kappa Cohen.

Results: In the concordance analysis between the clinical findings of bluish skin color and the low-flow component on Doppler ultrasound, a strong concordance Kappa value (K = 0.664) was found, which was significant (p = 0.000). In the concordance analysis of compressibility sign on clinical findings and compressibility on ultrasound findings, the Kappa measure of agreement yielded a very strong suitability (K = 1,000) which was significant (p = 0,000).

Conclusion: There is a strong significant agreement between the clinical findings of a bluish skin color with a venous component and clinical findings of no change in skin color with a lymphatic component in venolymphatic malformations. There was a very strong significant concordance between compressibility signs on clinical findings and compressibility signs on ultrasound findings in venolymphatic malformations."