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PENDAHULUAN
Ultrasound merupakan salah satu modalitas radiologi
sagital
transversal
Transversal viewed
LIVER
TEKNIK SCANNING
Ligamentum teres
Variant Normal
Fatty Liver peningkatan ekogenisitas hepar
PATOLOGI HEPAR
METASTASIS
Tumor sekunder
Polimorfik
ekogenik : kolorektal Ca
hipoekoik : Ca mammae / Ca paru
Bulls eye : perihipoekoik halo / rim
Multipel
Pendesakan struktur di sekitarnya ; vaskuler / duktus
biliaris
toxin substance
hcc
hcc
Hipertensi Portal
Sekunder terhadap sirosis / adanya massa
Dilatasi v. porta > 13 mm hipertensi portal
v. porta
Vesika Felea
Teknik scanning
1. Gallstone
Kolesterol / kalsium
echogenic band dg acoustic shadow
dipastikan dengan perubahan posisi pasien
dislodge ~ polip
2. Kolesistitis
Inflamasi di vesika felea, biasanya k/ batu
Awal hanya nyeri tekan
GINJAL
Anatomy
Kidneys are retroperitoneal, T12 - L4
Right kidney is lower than the left kidney
Right kidney is posterio-inferior to liver &
gallbladder
Left kidney is inferior-medial to the spleen
Adrenal glands are superior, anterior, medial to each
kidney
Hepatic
Veins
Anatomy
Spleen
Celiac
axis
Liver
Renal artery
AORTA
Renal vein
IVC
Right
kidney
SMA
Left
kidney
Anatomy
9-12 cm long, 4-5 cm wide, 3-4 cm thick
Gerotas fascia encloses kidney, capsule, perinephric
fat
Sinus
Medullary pyramids
Kidney
Anatomy
Minor
Calyx
Renal artery
Major
Calyx
Renal vein
Sinus
Medulla
Renal capsule
Cortex
Ureter
Sonographic Appearance
Ureters are normally not seen
Renal pelvis is black when visible
Renal sinus is echogenic due to fat
Medullary pyramids are hypoechoic
Cortex is mid-gray, less echogenic than liver or
spleen.
Capsule is smooth and echogenic
Anterior
Superior
Liver
Inferior
Sinus
Cortex
Diaphragm
Posterior
Anterior
Right
GB Liver
Left
IVC
R Kidney
Vertebral
Body
Posterior
Aorta
Renal a.
Anterior
Inferior
Superior
Rib
Shadow
Kidney
Posterior
Spleen
Anterior
Right
Left
Liver
Spleen
L Kidney
Posterior
Obstructive Uropathy
Grading System - Subjective
Mild
Minimal separation of calyces
Moderate
Severe
Range of Hydronephrosis
Normal
Mild
Moderate
Severe
Mild Hydronephrosis
GB
Kidney
Liver
GB
Liver
Kidney
Dilated pelvis
Renal Pathology
1. Renal Cysts
Renal Cysts
multiple
Cysts do not communicate; hydronephrosis does
Shape is round or oval
Echo free
Sharp interface between the mass and renal tissue
Large renal cysts may be mistaken for aortic
aneurysms
Renal Cysts
PANKREAS
Penilaian Pankreas
Ukuran
Ekogenisitas parenkim
Kalsifikasi
massa
Ukuran normal
kaput
korpus
kauda
: < 3 mm
: < 2,5 mm
: < 2,5 mm
PANKREATITIS
Penyebab
VESIKA URINARIA
b
a
Vol = A x B x C x 0,52
Prostat
PENILAIAN PROSTAT
Ukuran Normal volume < 25 cc
Kalsifikasi
Nodul?
Kapsul
Hipertrofi Prostat
tampak penebalan
Hipertrofi lanjut stenosis urethra dinding V U tebal
Ca Prostat
Muncul dari perifer
Infiltrasi dinding V U
Massa lobulated dalam lumen V U
Emergency
Ultrasound
HEMOPERITONEUM
METASTASE HEPAR
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