Tesis

Hubungan antara Diameter Anteroposterior, Kraniokaudal, dan Laterolateral Efusi Pleura Menggunakan CT-Scan Toraks Kontras Intravena dengan Volume Efusi Pleura Pada Volumetri = The Relationship Between the Anteroposterior, Craniocaudal, and Laterolateral Diameters of Pleural Effusion Using Contrast-Enhanced Chest CT Scan and the Volume of Pleural Effusion on Volumetry.

Latar Belakang: Efusi pleura merupakan akumulasi cairan abnormal di rongga pleura yang sering dijumpai pada berbagai kondisi klinis, seperti gagal jantung, pneumonia, trauma, dan keganasan. Penentuan volume efusi pleura sangat penting dalam tatalaksana, terutama untuk indikasi torakosentesis. Volumetri menggunakan CT-Scan merupakan metode paling akurat, namun tidak tersedia di semua fasilitas radiologi. Oleh karena itu, diperlukan formula estimasi berbasis parameter linier efusi pleura yang dapat diaplikasikan secara praktis. Tujuan: Menilai hubungan antara diameter anteroposterior (AP), kraniokaudal (KK), dan laterolateral (LL) efusi pleura serta rongga toraks dengan volume efusi pleura berdasarkan volumetri CT-Scan, dan menyusun formula estimasi volume yang akurat. Metode: Penelitian observasional analitik dengan desain potong lintang menggunakan data sekunder CT-Scan toraks kontras intravena dari 85 pasien dewasa dengan efusi pleura di RSUPN Dr. Cipto Mangunkusumo periode Januari 2024–Agustus 2025. Volume efusi diukur dengan manual contouring menggunakan aplikasi syngo.via. Analisis korelasi dilakukan dengan uji Pearson atau Spearman, sedangkan pemodelan formula dilakukan dengan regresi linier. Hasil: Ditemukan korelasi kuat antara diameter AP dan KK efusi pleura dengan volume efusi (p < 0,001), korelasi sedang pada diameter LL efusi, serta korelasi lemah pada parameter rongga toraks. Formula terbaik diperoleh dari kombinasi luas area maksimal efusi dengan tinggi efusi (Volume = 25,37 + 0,54 × A × h), dengan koefisien determinasi R² = 0,932 dan kesalahan estimasi rata-rata 59,96 mL. Kesimpulan: Parameter linier efusi pleura pada CT-Scan, terutama luas area dan tinggi efusi, terbukti memiliki korelasi kuat dengan volume efusi dan dapat digunakan sebagai dasar perhitungan estimasi yang akurat. Temuan ini berpotensi membantu klinisi dalam menentukan tatalaksana pasien secara lebih tepat ketika volumetri tidak tersedia.
Kata Kunci: CT-Scan toraks, diameter anteroposterior, kraniokaudal, laterolateral, efusi pleura, luas area, volumetri.


Background: Pleural effusion is the abnormal accumulation of fluid in the pleural cavity and is commonly encountered in various clinical conditions, such as heart failure, pneumonia, trauma, and malignancy. Accurate determination of pleural effusion volume is essential for clinical management, particularly in guiding indications for thoracentesis. CT-based volumetry is the most accurate method; however, it is not available in all radiology facilities. Therefore, a practical estimation formula based on linear parameters of pleural effusion is needed. Objective: To evaluate the relationship between the anteroposterior (AP), craniocaudal (CC), and laterolateral (LL) diameters of pleural effusion and thoracic cavity parameters with pleural effusion volume as determined by CT-based volumetry, and to develop an accurate volume estimation formula. Methods: This was an analytic observational study with a cross-sectional design using secondary data from contrast-enhanced thoracic CT scans of 85 adult patients with pleural effusion at Dr. Cipto Mangunkusumo National General Hospital between January 2024 and August 2025. Pleural effusion volume was measured using manual contouring with the syngo.via application. Correlation analysis was performed using Pearson or Spearman tests, and formula modeling was conducted using linear regression analysis. Results: Strong correlations were found between the AP and CC diameters of pleural effusion and effusion volume (p < 0.001), a moderate correlation was observed for the LL diameter of the effusion, and weak correlations were noted for thoracic cavity parameters. The best-performing formula was derived from a combination of the maximal effusion area and effusion height (Volume = 25.37 + 0.54 × A × h), with a coefficient of determination (R²) of 0.932 and a mean estimation error of 59.96 mL. Conclusion: Linear parameters of pleural effusion on CT imaging, particularly effusion area and height, demonstrate a strong correlation with effusion volume and can serve as a reliable basis for accurate volume estimation. These findings may assist clinicians in making more informed management decisions when CT-based volumetry is not available.
Keywords: anteroposterior diameter, area, craniocaudal diameter, laterolateral diameter, pleural effusion, thoracic CT scan, volumetry.