DETEKSI KEBOCORAN CAIRAN LIQUOR DENGAN PEMERIKSAAN SPECT/CT SISTERNOGRAFI RADIONUKLIDA

  • Kharisma Perdani Kusumahstuti Nuclear Medicine and Theranostic Molecular, Hasan Sadikin General Hospital
  • David Siahaan Nuclear Medicine and Theranostic Molecular Department, Hasan Sadikin General Hospital
  • Rian Hidayatullah Nuclear Medicine and Theranostic Molecular Department, Hasan Sadikin General Hospital
  • Achmad Hussein Sundawa Kartamihardja Nuclear Medicine and Theranostic Molecular Department, Hasan Sadikin General Hospital
Keywords: Cisternography Radionuclide Cerebrospinal Fluid

Abstract

Radionuclide cisternography is often used to prove the presence of cerebrospinal fluid leakage from the nose or ears and to localize the location of the leak. Whether the leak is active or not at the time of examination greatly affects the results of the radionuclide examination. We report a rare study case in a female patient  56 years old, who had the main complaints of nasal discharge, apathy, and weakness. The discharge is mainly felt when the patient is sitting. The patient had a history of transsphenoidal surgery for removal tumor at the epiphyses. Cisternography examination was carried out at the Department of Nuclear Medicine and Molecular Theranostic to confirm a liquor leak in the patient. Imaging was performed at 1.3.6 hours after intrathecal 99mTc-DTPA injection. There is an increase in radioactivity in the nasal area, especially on the 3 hour image. SPECT / CT fusion imaging provides the exact location of the liquor leak at the sphenoid area. The nasal tampon to blood serum ratio is 4: 1. Therapy for the patient is surgery to re-seal the leak.

Author Biographies

David Siahaan, Nuclear Medicine and Theranostic Molecular Department, Hasan Sadikin General Hospital

Pendidikan

  • SD : SDN Kalisari 02 Jakarta
  • SMP : SMP 102 Jakarta
  • SMA : SMA 39 Jakarta
  • S1 : Fakultas Kedokteran UNPAD

 

 

 

Riwayat Pekerjaan

 

  • 2010-2012 : Dokter Batalyon 142 KJ Jambi
  • 2013-2014 : Pakes Timbankes Denkeslap Kesdam Jaya
  • 2014-2015 : Kaurkesmil Kesdam Jaya
  • 2016-2018 : Kasikesmil Kesdam Jaya

 

 

Organisasi

Ikatan Dokter Indonesia

Perhimpunan Kedokteran Nuklir Indonesia

Rian Hidayatullah, Nuclear Medicine and Theranostic Molecular Department, Hasan Sadikin General Hospital

RIWAYAT PENDIDIKAN

Tahun Lulus

Program Pendidikan

Asal Sekolah

Jurusan/Program Studi

2003

SD

SDN 26 Mataram

-

2006

SMP

SMPN 6 Mataram

-

2009

SMA

SMAN 1 Mataram

IPA

2013

Sarjana

Universitas Mataram

Kedokteran

2015

Pendidikan Dokter

Universitas Mataram

Kedokteran

 

 

PENGALAMAN PEKERJAAN

Tahun

Posisi

Tempat Bekerja

Februari 2016 – November 2016

Dokter Internsip

RSUD KLU, KLU, NTB

November 2016 – Februari 2017

Dokter Internsip

PKM Kayangan, KLU, NTB

September 2017–Desember 2018 

Dokter Umum

RSUD Kota Mataram, NTB

Mei 2017 – Desember 2018

Dokter Umum

Blue Island Medical Clinic

 

 

 

 

 

 

 

PELATIHAN PROFESIONAL / NON FORMAL

Tahun

Jenis Pelatihan (Dalam/Luar Negeri)

Penyelenggara

Jangka Waktu

2017

Advanced Trauma Life Support

Komisi Trauma Perhimpunan Dokter Spesialis Bedah Indonesia

3 hari

2017

Advanced Cardiac Life Support

Perhimpunan Dokter Spesialis Kardiovaskuler Indonesia

3 hari

2018

Emergency Electrocardiography Course

Perhimpunan Dokter Spesialis Kardiovaskuler Indonesia DKI Jaya

2 hari

 

 

 

PENGALAMAN PENELITIAN

Tahun

Judul Penelitian

2012

 

 

2019

 

 

2021

Perbandingan Nilai FEV1 antara Ibu Rumah Tangga Perokok Pasif dan Bukam Perokok Pasif

 

Etiology and Renogram Pattern of Congenital Hydronephrosis: A Retrospective Study in Hasan Sadikin Hospital (2012-2019)

 

Radioactive Iodine Therapy in Graves’ Disease with Anxiety Affect Adjustment Disorder: a case report

 

PUBLIKASI ILMIAH

Tahun

Judul

2021

 

2021

 

Peptide Receptor Radionuclide Therapy: a literature review

 

Somatostatin: a literature review

 

 

 

 

 

 

 

 

 

 

 

 

 

KONFERENSI/SEMINAR/LOKAKARYA/SIMPOSIUM

Tahun

Judul Kegiatan

Penyelenggara

Panitia/ peserta/ pembicara

2011

Rapat Koordinasi Wilayah IV Ikatan Senat Mahasiswa Kedokteran Indonesia

FK Universitas Mataram dan Ikatan Senat Mahasiswa Kedokteran Indonesia

Panitia

2014

Musyawarah Kerja Nasional IDI XX

IDI dan FK Universitas Mataram

Panitia

2016

The 2nd Lombok Cardiovascular Update

State of the Art Advances in Cardiovascular Emergency : Form Pre-Hospital to Post-Hospital Care in Rural Territories

IDI, PERKI, dan FK Universitas Mataram

Peserta

 

2016

Simposium

Mataram Metabolic Update 2016

Diabetes Mellitus : A Current Comprehensive Management Towards Multidiscipline Perspectives

IDI dan PAPDI

Peserta

2017

Seminar Tatalaksana Terkini Kelainan Bidang THT-KL di Layanan Primer dan Workshop Cuci Hidung, Ekstraksi Serumen, dan Benda Asing di Telinga

IDI dan PERHATI-KL

Peserta

2017

Seminar “Adult Hypertension On Clinical Practice Update” Dalam Rangkaian Annual Meeting Forum Kedokteran Islam Indonesia (FOKI 2017)

IDI, Alumni Kedokteran Unizar, FOKI, dan Unizar

Peserta

2017

Seminar Emerency Update & Early Warning System

IDI, Perhimpunan Dokter Ahli Emergensi Indonesia, RSUP NTB, dan PPNI

Peserta

2017

Workshop

Stroke : Emergency Setting

IDI dan Perhimpunan Dokter Spesialis Saraf Indonesia

Peserta

2018

Simposium

Mataram Metabolic Update 2018

“Current Updates and Intensifying Management in Metabolic Endocrine Disorder”

IDI dan PAPDI

Peserta

2019

I-CONCERN-19: International Conference on Nuclear Capacity Building, Education, Research, and Applications – PIT PKNI

Perhimpunan Kedokteran Nuklir Indonesia

Panitia

2021

Workshop Prostate Cancer, Bandung

Perhimpunan Kedokteran Nuklir Indonesia

Panitia

2022

Workshop Hands On Orthopaedic in Daily Practice – PIT IDI Cabang Kota Bandung

IDI Kota Bandung

Peserta

Achmad Hussein Sundawa Kartamihardja, Nuclear Medicine and Theranostic Molecular Department, Hasan Sadikin General Hospital
  1. Kartamihardja AHS. Current Status of Hepatocellular Carcinoma in Indonesia. Presented on IAEA Regional Training Workshop on Radionuclide Treatment of Liver Cancer, Singapoe 14-18 Feb 2000. (Tinjauan Pustaka)
  2. Kartamihardja AHS.   Tc-99m Sestamibi Scintimammography in the Diagnosis of Breast Cancer. Presented in IAEA-PAEC Regional Workshop on Scintimammography, Sentinel Lymph node Detection and Intraoperative Surgical Probe Technology in the Management of Breast Cancer. Islamabad, Pakistan, 9-13 April 2001.(Tinjauan Pustaka)
  3. Kartamihardja AHS. Pelayanan Kedokteran Nuklir Melalui Kerjasama Operasional (KSO) di RSUP Dr. Hasan Sadikin Bandung. Disampaikan pada Semiloka Pengembangan Pelayanan Kedokteran Nuklir dan Radioterapi sebagai Profit Center di Rumah Sakit, Jakarta, 31 Mei 2001.(Tinjauan Pustaka)
  4. Kartamihardja AHS. Penggunaan radionuklida pada pencitraan perfusi dan evaluasi viabilitas miokard. Disampaikan pada Pertemuan Ilmiah Tahunan Perhimpunan  Dokter  Spesialis  Radiologi  Indonesia,  Yogyakarta,  14  Juli 2001.(Tinjauan Pustaka)
  5. Kartamihardja   AHS.   The   Role   of   Nuclear   Medicine   on   Pulmonary Embolism. Presented in IAEA-INMO Advanced National Training Course on Nuclear Medicine, We Madani, Sudan 3-7 Nov 2001.(Tinjauan Pustaka)
  6. Kartamihardja AHS. Nuclear Medicine in Paediatric. Presented in IAEA- INMO  Advanced  National  Training  Course  on  Nuclear  Medicine,  We Madani, Sudan 3-7 Nov 2001.(Tinjauan Pustaka)
  7. Kartamihardja AHS. The Role of Nuclear Medicine on Infection and Inflammation.  Presented  in  IAEA-INMO  Advanced  National  Training Course on Nuclear Medicine, We Madani, Sudan 3-7 Nov 2001.(Tinjauan Pustaka)
  8. Kartamihardja AHS. Myocardial Perfusion Imaging. Presented in IAEA- INMO Advanced National Training Course on Nuclear Medicine, Wed Madani, Sudan 3-7 Nov 2001.(Tinjauan Pustaka)
  9. Kartamihardja AHS. Peranan Teknik Kedokteran Nuklir dalam Penentuan Fokus Infeksi. Kumpulan Makalah Pertemuan Dwi Tahunan PKBNI-PKNI- BATAN 2002.(Tinjauan Pustaka)
  10. Kartamihardja AHS. Peranan Teknik Kedokteran Nuklir dalam Bidang Kesehatan. Disampaikan Seminar Pendayagunaan Reaktor TRIGA dalam Mendukung Program Pembangunan Nasional. Bandung, 4 Februari 2002.(Tinjauan Pustaka)
  11. Kartamihardja AHS. Aspek klinis radioisotop/senyawa bertanda dalam kedokteran. Disampaikan pada Pelatihan Teknologi    Proses  Produksi Radioisotop dan Senyawa Bertanda. Bandung, 5-16 Agustus 2002.(Tinjauan Pustaka)
  12. Kartamihardja AHS. Peranan Teknik Kedokteran Nuklir dalam Penentuan Fokus Infeksi. Disampaikan pada Pertemuan Ilmiah PKBNI/PKNI, Jakarta 18-19 September 2002.(Tinjauan Pustaka)
  13. Kartamihardja AHS, Current Status of Nuclear Medicine on Oncology in Indonesia. Disampaikan pada ARCCNM Symposium, Jakarta, September 2003.(Tinjauan Pustaka)
  14. Kartamihardja AHS, Peranan Kedokteran Nuklir dalam Diagnosis dan Follow-up Penderita Penyakit            Jantung. Disampaikan pada Semiloka Kedokteran Nuklir, Yogyakarta, 12 Juni 2004. (Tinjauan Pustaka)
  15. Kartamihardja AHS, Peranan Kedokteran Nuklir pada Nefro-urologi. Disampaikan pada Seminar Pendayagunaan           Kedokteran Nuklir untuk Pelayanan Kesehatan Ginjal Jakarta, 20 Agustus 2004.(Tinjauan Pustaka)
  16. Kartamihardja AHS, Mekanisme Lokalisasi Radiofarmaka. Disampaikan pada Pelatihan Radiofarmasi untuk Staf Pengajar Farmasi   Perguruan Tinggi Serpong-Jakarta 28 September 2004. (Tinjauan Pustaka)
  17. Kartamihardja AHS, Interpretasi hasil pencacahan dan pencitraan radionuklida. Disampaikan pada Pelatihan Radiofarmasi untuk Staf Pengajar Farmasi Perguruan Tinggi Serpong-Jakarta 28 September 2004. (Tinjauan Pustaka)
  18. Kartamihardja AHS. Peranan Kedokteran Nuklir dalam Pengelolaan Penyakit Ginjal dan Saluran Kemih. Disampaikan pada Seminar Pemasyarakatan hasil penelitian teknologi nuklir BATAN, RSUD Dr. Slamet, Garut 22 Maret 2005.
  19. Kartamihardja  AHS.  Aplikasi  Teknik  Nuklir  dalam  Bidang  Kedokteran. Disampaikan  pada  Diklat  Introduksi  Teknik  Nuklir  bagi  Guru  SMU  di Bandung. Juli 2005.
  20. Kartamihardja AHS. The Role of Nuclear Medicine on Detection and Localization of Infection and Inflammation. Disampaikan pada Konas PDSRI, Jogyakarta, Juli 2005.
  21. Kartamihardja AHS. Nuclear Oncology in Indonesia. Disampaikan pada Lunch Symposia” Peranan Kedokteran Nuklir Pada Penatalaksanaan Tumor. Jakarta, 21 September 2005.
  22. Kartamihardja AHS. Peranan Kedokteran Nuklir dalam Nefrourologi. Disampaikan           pada Seminar dan Pemeriksaan Ginjal ”Pemanfaatan Teknologi Kedokteran Nuklir di Bidang Nefrologi”. Jakarta, 29-30 Nopember 2005.
  23. Kartamihardja AHS. Pencitraan Tc-99m Cyprofloxacine dibandingkan dengan Tc-99m HMPAO-WBC pada Penderita Infeksi Tulang dan Sendi. 2006; XXXVIII (2): 59-65. (Penelitian)
  24. Kartamihardja AHS. Pencitraan dengan Radionuklid Tc-99m-Ethambutol untuk Diagnosis Tuberkulosis Extra Pulmonal (Penelitian pada hewan percobaan). 2006; XXXVIII (3): 116-121.(Penelitian).

 

Pelatihan dan Fellowship

  1. Workshop on Quality Control of Nuclear Medicine Instruments, IAEA- BATAN Bandung, Indonesia, April 1985.
  2. Post Graduate Training Course on Nuclear Medicine, ANSTO-RPAH Sydney, Australia 1985 - 1986.
  3. Training Course on Nuclear Medicine Data Processing, Nagoya Cancer Centre, Japan, April 1986.
  4. Regional Train-the Trainers Course on Data Processing in Radioimmunoassay, IAEA-BATAN, Jakarta Indonesia, Juli 1987.
  5. Workshop on Radio-aerosol Inhalation Lung Imaging in Developing Countries, IAEA-BARC Bombay, India 1987.
  6. Interregional Training Course on Nuclear Medicine, IAEA-CIAMS, Moscow-USSR, September – Nopember 1987.
  7. The National Course on the Application of Nuclear Technique in Medicine, BATAN-ANSTO-RSHS, Bandung 1988.
  8. Training on SPECT Camera, RoosvilleHospital, San Jose, USA, 1988.
  9. Workshop on Liver Imaging, IAEA-Seoul Catholic Hospital, Seoul, Korea, 1989.
  10. Regional Training Course on the Use of Computer in Nuclear Medicine, IAEA-ANSTO, Sydney Australia, 1990.
  11. Training Course on Nuclear Medicine, Dept. of Nuclear Medicine, St. Germain en Laye Hospital, Paris, Perancis, 1994.
  12. Fellowship on Nuclear Medicine, IAEA-St. Bartholomews Hospital, London UK, 1995 - 1996.
  13. RCA Training Course  on  Application of  Positron  Emission  Tomography (PET) in Clinical Practice for Nuclear Medicine Physicians. IAEA- Cardiovascular Institute Fu Wai Hospital. Beijing, China, 2000.
  14. RCA Training Workshop on Scintimammography, Sentinel Lymph Node Detection and Intra-Operative Surgical Probe Technology, IAEA-NORI, Islamabad, Pakistan, 2001.
  15. RCA Training Course on Myocardial Perfusion Scintigraphy for Nuclear Medicine Physicians. IAEA-NIRS Chiba, Japan, 2003.
  16. RCA Training Course on Interventional Nuclear Medicine. IAEA-New Delhi, India, 2003.
  17. Pelatihan Pengadaan barang/jasa pemerintahan (Kepres nomor 80 tahun 2003). LBI- Jakarta 2004.
  18. Pelatihan dan Ujian Nasional Sertifikasi Pengadaan barang/jasa pemerintahan (Kepres nomor 80 tahun 2003), Surabaya, April 2005.
  19. IAEA/RCA Project Planning  Meeting on “Tumour Imaging Using Radioisotopes” Chiba, Japan, April 2005.
  20. RCARO/UNDP Regional Training Course on SPECT/PET Imaging Science and Technology, Seoul, Korea, 18 – 23 June 2012

 

Jabatan

  1. Koordinator Program Studi Ilmu Kedokteran Nuklir FK UNPAD pada tahun 2014 – sekarang
  2. Ketua Kolegium Perhimpunan Kedokteran Nuklir Indonesia : tahun 2006 –sekarang
  3. Penasehat  Perhimpunan  Kedokteran  Nuklir  Indonesia   :  tahun  2013  –sekarang
  4. Penasehat Perhimpunan Kedokteran Nuklir dan Biologi Indonesia  : tahun 2013 – sekarang.
  5. Country Principal of Asian School of Nuclear Medicine
  6. Editorial Board of World Journal of Nuclear Medicine
  7. Editorial Board of Asia Oceania Journal of Nuclear Medicine

 

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Published
2022-06-30
Section
Case Report

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