Validitas Foto Thorax Proyeksi Posterio-Anterior untuk Menegakkan Diagnosis Emfisema Pulmonum

Abstract

Emphysema as a condition of lung characterized by abnormal, permanent enlargement of airspaces distal to the terminal bronchiole, accompanied by destruction of their walls. At first chronic inflammatory induced changed the lung structure. The abnormality of lung structure can manifest in Posterio-anterior chest X-ray. Posterio-anterior chest X-ray has good validity to establish change the lung structure. Posterio-anterior chest X-ray was a simple examination and cheap as good as spirometry for a gold standard. This study maintained to get validity of Posterioanterior chest X-ray to establish diagnosis of emphysema.This study is a diagnostic test were that performed in Departement of Radiology RSUD Dr Moewardi Surakarta from July to October 2008. Samples of this study recruited were 192 subjects with range of age between 18-81 years old, 154 men and 38 women. emphysema was diagnosed if Posterio-Anterior chest X-ray showed : 1)Hyperinflation 2) Hyperlucency 3) Decrease and flattened of diaphragma and 4) Tear drop appearance of the heart, to determine either emphysema or non emphysema. emphysema was diagnosed if met with all criteria above. Spirometry showed obstruction with criteria of GOLD 2006, mild obstruction if FEV1/ FVC < 70%, FEV1 > 80% predicted, moderate obstruction if FEV1/FVC < 70%, 50%< FEV1<80% predicted, severe obstruction if FEV1/FVC < 70%, 30%< FEV1<50% predicted and very severe obstruction if FEV1/FVC < 70%, FEV1< 30% or FEV1<50% predicted plus chronic respiratory failure. F r om 1 9 2 s u b j e c t s performed Posterio-Anterior chest X-ray, 126 subjects (66%) were diagnosed with emphysema and non emphysema were diagnosed in 66 subjects (34%). Posterio-Anterior chest X-ray emphysema with obstruction were establishe in 117 subjects (93%) and non obstruction were diagnosed in 9 subjects (7%). Posterio-Anterior chest Xray non emphysema with obstruction were diagnosed in 12 subjects (18%) and non obstruction were diagnosed in 54 subjects (82%). Smoking habits was higher in emphysema Posterio-anterior chest X-ray group than non emphysema group. The validity of Posterio-Anterior chest X-ray to establish diagnosis of emphysema was 90.6% in sensitifity and 84.3% in spesifisity. Posterio-Anterior chest X-ray has good validity to establish diagnosis emphysema. Posterio-anterior chest X-ray was a simple examination and cheap as good as spirometry for a gold standard.