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"Paralisis diafragma pasca operasi penyakit jantung bawaan dapat meningkatkan mortalitas dan morbitas pasien. Penegakkan diagnosa kelainan ini menjadi kunci untuk pengambilan keputusan tindak lanjut seperti plikasi diafragma. Fluoroskopi sebagai baku emas memiliki keterbatasan untuk dilakukan pada pasien pasca operasi penyakit jantung bawaan. Dari 2.287 operasi penyakit jantung yang dilakukan di RSJPDHK terdapat 41 pasien yang memenuhi kriteria inklusi dan eksklusi. Median usia pasien 10 (1-119) bulan dan 43,9% berjenis kelamin laki-laki. Terdapat perbedaan bermakna pada jenis operasi yang dijalani. Dari hasil perhitungan didapatkan sensitivitas dan spesifisitas USG diafragma dibandingkan fluoroskopi pada subjek penelitian sebesar 100%(95%CI 82,35%-100%) untuk sensitivitas, dan 95.5%(95% CI 77,16%-99,88%) untuk spesifisitas. Lebih lanjut dilakukan perhitungan nilai prediksi positif dengan hasil 95%(95%CI 73,68%-99,27%) dan nilai prediksi negatif 100% (95% CI 83,89%-100%). Ultrasonografi memiliki sensitivitas dan spesifisitas yang baik dibandingkan fluoroskopi sebagai metode diagnostik pada populasi dengan kecurigaan paralisis diafragma pasca operasi penyakit jantung bawaan dengan sensitivitas 100% dan spesifisitas 95.5%.

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Diaphragmatic paralysis after congenital heart disease surgery can increase patient mortality and morbidity. Establishing a diagnosis of this disorder is key for making follow-up decisions such as diaphragm plication. Fluoroscopy as the gold standard has limitations for performing post-surgical patients with congenital heart disease.This study is a comparative diagnostic study that evaluates the ability of diaphragmatic ultrasound to diagnose diaphragmatic paralysis in patients with suspected diaphragmatic paralysis after surgery for congenital heart disease at RSJPDHK from June 2022 to May 2024. Each diaphragmatic ultrasound result was recorded and compared with the findings on fluoroscopy examination. Of the 2,287 heart surgery performed at RSJPDHK, there were 41 patients who met the inclusion and exclusion criteria. The median patient age was 10 (1-119) months and 43.9% were male. There are significant differences in the type of surgery undertaken. From the calculation results, it was found that the sensitivity and specificity of diaphragm ultrasound compared to fluoroscopy in research subjects was 100% (95% CI 82.35% - 100%) for sensitivity, and 95.5% (95% CI 77.16% - 99.88%) for specificity. Furthermore, the positive predictive value was calculated with results of 95% (95% CI 73.68%-99.27%) and negative predictive value of 100% (95% CI 83.89%-100%). Ultrasonography has good sensitivity and specificity compared to fluoroscopy as a diagnostic method in the population with suspected diaphragmatic paralysis after surgery for congenital heart disease with a sensitivity of 100% and a specificity of 95.5%."

"Tujuan: Mengetahui sensitivitas dan spesifisitas Ultrasonografi Doppler Berwarna (USG DB) dibandingkan dengan pemeriksaan histopatologi dalam menilai metastasis kelenjar getah bening (KGB) aksila level I pada pasien karsinoma payudara (KPD).Saban dan Metode: Pemeriksaan USG DB dilakukan pada 39 KGB aksila dari 17 pasien yang memenuhi kriteria penerimaan. USG DB menilai KGB dengan B-mode, Color mode clan Doppler mode untuk kemudian dibandingkan dengan pemeriksaan histopatologi, Pemeriksaan dilakukan menggunakan transduser linear frekuensi 10 MHz (GE, Logiq 3).Hasil penelitian: Pada pemeriksaan USG Doppler mode didapatkan sensitivitas 73,3%, spesifisitas 87,5%, yang bennakna secara statistik. Pemeriksaan USG Co/or mode mempunyai nilai kappa dan spesifisitas yang rendah, meskipun bermakna secara statistik. Pemeriksaan USG lainnya (B-mode maupun kombinasi) tidak memberikan hasil yang bermakna.Kesimpulan: Pemeriksaan USG Doppler mode mempunyai sensitivitas dan spesifisitas yang baik dan bermakna secara statistik. Hal ini diharapkan dapat membantu klinisi dalam menilai metastasis kelenjar getah bening aksila secara non-invasif.

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Objective: To establish sensitivity and specificity of Color Doppler Ultrasound (CDU) in the assessment of level ! axillary lymph nodes metastases in breast cancer patients.

Material and methods:. CDU was performed in 39 aril/my lymph nodes from 17 patients, to evaluate B-mode, Color erode dan Doppler mode images in comparison with histopathologic finding of metastases. CDU examination was performed using linear transducers 1OMHz (GE, Log-4 3).

Results: The sensitivity and specificity of Doppler mode in CDU were 73,3% and 87,5%, and they were statistically significant. Although color mode evaluation was statistically significant, its specificity and kappa value are low. Other evaluations such as B-mode or combination mode gave unsignificant results,

Conclusion: Doppler mode in CDU examination has a good sensitivity and specificity in detecting axillary lymph nodes metastases. It is considered useful for the clinicians in evaluating lymph nodes status using non-invasive procedure."

"This book will be a welcome resource for any physician or health care practitioner looking to further their knowledge and skills in point-of-care ultrasound."

"Penelitian ini bertujuan untuk mengevaluasi penggunaan ultrasonografi sebagai pemeriksaan pelengkap mamografi dalam mendeteksi awal kelainan payudara berdasarkan perbedaan densitas payudara pada mamografi.Rumusan MasalahKepadatan payudara menurunkan tingkat kepekaan mamografi sehingga dapat terjadi false negatif pada mamografi. Sehingga diperlukan pemeriksaan yang non invasif dan relatif murah seperti ultrascnografi untuk meningkatkan kepekaan mamografi.Berdasarkan uraian dalani latar belakang masalah di alas maka dapat dirumuskan beberapa pertanyaan penelitian antara lain :1. Gradasi berapa pada mamogram yang memerlukan ultrasonografi sebagai pemeriksaan tambahan mamografi,2. Berapa peningkatan kepekaan mamogram yang tidak ditemukan massa dengan penggunaan ultrasonografi sebagai pemeriksaan pelengkap dalam mengevaluasi kelainan payudara."

"This book presents some of the recent advances in Ultrasound imaging technology covering several organs and techniques in a Biomedical Engineering (BME) perspective. The focus of the book is in the algorithms, methodologies and systems developed by multidisciplinary research teams of engineers and physicians for Computer-Aided Diagnosis (CAD) purposes.Cardiovascular and Cancer, the most common life-threatening diseases in western countries, are two of the most important topics focused in the book. However, other advanced issues are also presented such as Intravascular Ultrasound, 3D US and Ultrasound in Computer-Aided Surgery (CAS). Some chapters are direct contributions from medical research groups where Ultrasound has also received great attention in the last decade. By this, new techniques based on Ultrasound were introduced in the clinical practice for diagnosis and therapeutics, mainly in hospital facilities."

"Sekitar 1% anak terlahir dengan penyakit jantung bawaan (PJB). Sebagian akan memerlukan kateterisasi jantung baik diagnosis maupun terapeutik. Prosedur ini memerlukan kooperasi pasien dan imobilisasi sehingga dibutuhkan anestesia yang mungkin berulang. Penelitian ini bertujuan melihat efek anestesia umum terhadap fungsi kontraktilitas jantung anak dengan PJB. Kontraktilitas jantung dilihat dari fraksi ejeksi dan TAPSE yang diukur dengan ekokardiografi. Pengukuran dilakukan sebelum anestesia umum, 5 menit pascaintubasi dan akhir tindakan kateterisasi. Metode penelitian kohort observasional dengan consecutive sampling telah dilakukan. Analisis dilakukan terhadap 42 anak berusia 6 bulan hingga 18 tahun dengan PJB yang menjalani kateterisasi jantung dalam anestesia umum pada periode Juni – Agustus 2018. Uji T-test berpasangan dilakukan untuk analisis perubahan fraksi ejeksi dan TAPSE dan analisis multivariat untuk melihat pengaruh usia, jenis PJB, lama dan jenis tindakan kardiologi terhadap perubahan kontraksi. Perubahan fraksi ejeksi turun bermakna pada 5 menit pascaintubasi dan akhir tindakan kardiologi dan TAPSE turun bermakna hanya pada 5 menit pascaintubasi. Pengaruh usia, jenis PJB, lama dan jenis tindakan kardiologi tidak bermakna terhadap perubahan fraksi ejeksi dan TAPSE. Dengan demikian diharapkan kewaspadaan dalam penanganan pasien PJB, termasuk ketika memberikan informasi sebelum persetujuan tindakan medis (informed consent), dan jika memungkinkan menghindari tindakan anestesia umum yang berulang.

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Approximately 1% of children borned with congenital heart disease (CHD). Some will require cardiac catheterization which repeated anesthesia may be needed. This study aims to see the effect of general anesthesia on the cardiac contractility in children with CHD. Cardiac contractility seen from ejection fraction and TAPSE as measured by echocardiography. Measurements were taken before general anesthesia, 5 minutes post-intubation and at the end of the catheterization. An observational cohort with consecutive sampling was conducted. Analysis was carried out on 42 children aged 6 months to 18 years with CHD who underwent cardiac catheterization under general anesthesia in the period June - August 2018. Paired T-test was performed to analyze changes in ejection fraction and TAPSE and multivariate analysis to analyze the effect of age, type of CHD, duration and type of cardiology intervention. Ejection fraction decreased significantly at 5 minutes post-intubation and at the end of cardiology intervention and TAPSE decreased significantly only at 5 minutes post-intubation. Changes of contratility was not significant affected by age, type of CHD, duration and type of cardiology intervention. Therefore, alertness in handling patients with CHD is expected, including when providing information prior to informed consent, and if possible avoid repeated general anesthesia."

"Fetal Heart Ultrasound, now in its second edition, has been written as a practical guide for the ultrasound examination of the fetal heart. The fetal heart is considered to be the most important and difficult part of a fetal examination. This book aims not only to clarify and simplify the approach to this examination, but also to define what a normal fetal heart should be, and underline just why this organ remains one of the best warning signs for fetal pathology. It will be useful to trainee and practicing ultrasonographers, ultrasound departments providing obstetric ultrasound services, and obstetricians, gynecologists, radiologists and midwives undertaking course in fetal ultrasonography."

"This book is a practical guide to the use of TEE (transoesophageal echocardiography) in the diagnosis of congenital heart disease (CHD). Beginning with an introduction to TEE for CHD, the following chapters describe procedures to be used for different cardiac conditions. 3D TEE allowing multi-dimensional perspectives is also covered."

"Latar Belakang: Penyakit arteri perifer (PAP) adalah manifestasi aterosklerosis sistemik, yang seringkali melibatkan penyandang diabetes melitus (DM) tipe 2. Tes ankle brachial index (ABI) telah digunakan sebagai penapis PAP, tetapi ABI normal belum menyingkirkan PAP. USG dupleks (UD) lebih sensitif namun lebih mahal daripada tes ABI, sehingga perlu diketahui karakteristik penyandang DM tipe 2 yang paling diprioritaskan untuk menjalani pemeriksaan UD.Tujuan: Tujuan penelitian ini adalah untuk membuktikan bahwa UD dapat mendeteksi PAP pada penyandang DM tipe 2 dengan ABI normal, mengenali gambaran UD PAP, dan mengenali karakteristik penyandang DM tipe 2 yang paling diprioritaskan untuk menjalani pemeriksaan UD.Bahan dan Cara Kerja: Penelitian ini menggunakan desain potong lintang dengan mengikutsertakan 40 tungkai. Setiap subyek menjalani roc ABI, pemeriksaan UD dan pen ilaian faktor-faktor risiko. Arteri-arteri ekstremitas bawah d iperiksa, dengan penilaian terhadap ketebalan kompleks intima media (KIM) arteri femoralis, adanya plak, dan evaluasi spektrum Doppler.Hasil: Dari pemeriksaan UD ditemukan PAP pada 50% (20 dari 40) tungkai. Gambaran UD PAP yang didapatkan berupa penebalan KIM arteri femoralis (20%, 4 dari 20 tungkai) dan adanya plak dengan spektrum Doppler yang masih normal di arteri-arteri ekstremitas bawah (100%, 20 dari 20 tungkai). Terdapat hubungaxi bermakna antara obesitas dan kejadian PAP (Rasio Odds = 22,45). Kesimpulan: Dari penelitian ini, kami menyimpulkan bahwa: 1) UD dapat mendeteksi PAP pada penyandang DM tipe 2 dengan A131 normal; 2) Gambaran UD PAP pada pasien-pasien tersebut berupa penebalan KIM arteri femoralis dan adanya plak dengan spektnim Doppler normal di arteri-arteri ekstremitas bawah; 3) Obesitas merupakan karakteristik penyandang DM tipe 2 yang paling diprioritaskan untuk menjalani pemeriksaan UD.

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Background: Peripheral arterial disease (PAD) is a manifestation of atherosclerosis disease, which commonly involves the non insulin dependent diabetes mellitus (NIDDM) patients. Ankle brachial index (A13I) test has been used as a screening test for PAD, but a normal ABI does not exclude PAD. Duplex ultrasonography (DU) is more sensitive but more expensive than ABI, so it is neccessaty to assess the characteristics q f NIDDM patiens who are mostly indicated to undergo DU examination.

Objectives: The objectives of this study are to prove that DU can detect PAD in NIDDM patients with normal ABI, to assess DU appearances of PAD, and to assess the characteristics of NIDDM patiens who are mostly indicated to undergo DU examination.

Materials and Methods: This study was conducted in a cross sectional design, which involved 40 legs. Every subject underwent ABI and DU examinations. Lower extremity arteries were examined, with assessment for femoral intitnal medial thickness (IMT), the presence of plaque, and evaluation of Doppler spectrum .1-or each artery. The risk factors were evaluated by anamnesis, physical examination and laboratory examination.

Results: From DU examination, as many as 50% (20 _ from 40 legs) are found to have PAD. The DU appearances q f PAD include increase_ femoral artery LMT (20%, 4 from 20 legs) and the presence of plaques with normal Doppler spectrums in the lower extremity arteries (100%, 20 from 20 legs). There was a significant relationship between obesity and the evidence of PAD (Odds ratio = 2 2, 45).

Conclusions: From this study, we conclude that: I) DU can detect PAD in NIDDM patients with normal ABI, 2) 7Tie DUI appearances of PAD in those patients include increase femoral arrey IMT and the presence of plaques with normal Doppler spectntras in the lower extremity arteries: 3) Obesity is the characteristic of NIDDM patients who are mostly indicated to undergo DU examination."