DAFTAR ISI

HALAMAN JUDUL ..................................................................................... i

HALAMAN PERSETUJUAN ...................................................................... ii
KKEASLIAN PENELITIAN ......................................................................... iii
KATA PENGANTAR .................................................................................. iv
DAFTAR ISI ............................................................................................... v
DAFTAR GAMBAR .................................................................................... vii
DAFTAR TABEL ........................................................................................ viii
INTISARI PENELITIAN .............................................................................. ix
ABSTRACT ................................................................................................ x
BAB I PENDAHULUAN ............................................................................. 1
A. Latar Belakang ................................................................................ 1
B. Rumusan Masalah .......................................................................... 6
C. Tujuan Penelitian ............................................................................ 6
D. Manfaat Penelitian .......................................................................... 7
E. Keaslian Penelitian .......................................................................... 7
BAB II TINJAUAN PUSTAKA .................................................................... 12
A. Tinjauan teori .................................................................................. 12
1. Pengertian MRI ......................................................................... 12
2. Komponen Dasar MRI ............................................................... 13
3. Prinsip Fisika MRI ..................................................................... 15
4. Pembobotan Citra MRI .............................................................. 23
5. Pulsa Sekuen MRI ..................................................................... 25
6. Sekuen Inversion Recovery ....................................................... 33
7. Kualitas Citra MRI ..................................................................... 37
8. Anatomi Vertebra Cervical ......................................................... 40
9. Prosedur Pemeriksaan MRI Cervical ......................................... 50

B. Kerangka Teori................................................................................ 53
C. Hipotesis ......................................................................................... 53
BAB III Metodologi Penelitian .................................................................. 55
A. Rencana Penelitian ......................................................................... 55
B. Kerangka Penelitian ........................................................................ 56
C. Variabel Penelitian .......................................................................... 56
D. Populasi dan Sampel ...................................................................... 57
E. Definisi Operasional ........................................................................ 58
F. Alat dan Bahan Penelitian ............................................................... 61
G. Prosedur Penelitian ......................................................................... 62
H. Pengolahan dan Analisis Data ........................................................ 65

v
BAB IV Hasil dan Pembahasan ................................................................ 67
A. Hasil ................................................................................................ 67
1. Karakteristik Sampel ................................................................... 67
2. Pengaruh Variasi Nilai Time Inversion (TI) terhadap Kualitas
Citra MRI Cervical Sagital Pada Sekuen Turbo Inversion
Recovery Magnitude (TIRM) ....................................................... 69
3. Perbedaan Variasi Nilai Time Inversion (TI) Terhadap Informasi
Anatomi MRI Cervical Sagital Pada Sekuen Turbo Inversion
Recovery Magnitude (TIRM) ....................................................... 74

B. Pembahasan ................................................................................... 80
1. Pengaruh Kualitas Citra dengan Variasi Time Inversion (TI)
pada Sequence TIRM Sagital pada Pemeriksaan MRI Cervical
Potongan Sagital ......................................................................... 82
2. Perbedaan Variasi Nilai Tl Terhadap Informasi Anatomi MRI
Cervical Pada Sekuen Turbo Inversion Recovery Magnitude
(TIRM) ......................................................................................... 87
3. Nilai TI yang Optimal Untuk Menghasilkan Kualitas Citra
Terbaik Pada MRI Cervical potongan Sagital dengan sekuen
TIRM ........................................................................................... 89
BAB V Kesimpulan dan Saran ................................................................. 87
A. Kesimpulan ..................................................................................... 92
B. Saran .............................................................................................. 93
Daftar Pustaka .......................................................................................... 94
Lampiran Penelitian .................................................................................. 97

vi
 DAFTAR GAMBAR

Gambar 2.1. Skema komponen dasar sistem pencitraan MRI

(Zhuo dkk, 2006) ................................................................... 13
Gambar 2.2. Skema gradien x, y, dan z serta irisan yang dihasilkan
(Bitar dkk, 2006) .................................................................... 14
Gambar 2.3. Spinning foton hidrogen (Bitar dkk, 2006) .............................. 16
Gambar 2.4. Presesi atom hidrogen dengan berbagai sudut
(Bitar dkk, 2006) .................................................................... 16
Gambar 2.5. Gambar 2.5 Pemberian pulsa RF serta terjadinya T1 dan T2
pada jaringan yang mengandung air dan lemak
(Bitar dkk, 2006) .................................................................... 19
Gambar 2.6. Gambar 2.6 Ilustrasi k-space. Daerah ditengah menyimpan
informasi bentuk kasar dari kontras. Sedangkan daerah tepi
menyimpan informasi tentang resolasi dan struktur
yang kecil (Bitar dkk, 2006) .................................................... 23
Gambar 2.7. Spatial encoding pada Konvensional Spin Echo
(Westbrook dan Kaut, 2011).................................................. 27
Gambar 2.8. Phase encoding pada Turbo Spin Echo konvensional
(Westbrook&Kaut, 2011) ....................................................... 27
Gambar 2.9. Diagram sekuen Inversion Recovery (Brown, 2003) .............. 29
Gambar 2.10. Kontras citra antara jaringan solid (kotak) dan cairan
(lingkaran) dengan variasi TI (Mitchell, 1999) ......................... 30
Gambar 2.11. Columna vertebra (Bontrager, 2018) ..................................... 41
Gambar 2.12. Atlas tampak superior (Long, 2016) ....................................... 43
Gambar 2.13. Axis (C2) tampak anterior (Bontrager, 2018) ......................... 44
Gambar 2.14. Vertebra cervical tipikal (C3-6) tampak superior
(Bontrager, 2018) ................................................................... 45
Gambar 2.15. Potongan axial diskus intervertebralis (Bontrager, 2018) ....... 46
Gambar 2.16. Anatomi Sagital MRI Cervical (George, 2012) ....................... 49
Gambar 4.1. Hasil Citra Variasi Time Inversion (TI) pada sekuen TIRM ..... 68

vii
 DAFTAR TABEL

Tabel 2.1 Nilai T1 dan T2 jaringan pada kuat medan magnet 1,5 Tesla
(Forshult, 2007) ......................................................................... 20
Tabel 2.2 Beberapa nama sekuen IR yang digunakan oleh vendor besar
(Bitar, 2006) .............................................................................. 37
Tabel 4.1 Karakteristik Volunteer pada penelitian yang telah dilakukan .... 67
Tabel 4.2 Hasil ukur Signal to Noise Ratio (SNR) ..................................... 69
Tabel 4.3 Hasil Uji Normalitas Data Shapiro-Wilk SNR Cervical Dengan
Variasi Time Inversion (TI) Pada Sekuen TIRM......................... 70
Tabel 4.4 Hasil Uji Regresi Linier SNR ..................................................... 71
Tabel 4.5 Hasil ukur Contrast to Noise Ratio (CNR) ................................ 72
Tabel 4.6 Hasil Uji Normalitas Data Shapiro-Wilk CNR Cervical Dengan
Variasi Time Inversion (TI) Pada Sekuen TIRM......................... 73
Tabel 4.7 Hasil Uji Regresi Linier SNR ..................................................... 74
Tabel 4.8 Hasil skoring Responden 1 dan Responden 2 .......................... 75
Tabel 4.8 Hasil Uji Kappa terhadap penilaian dua responden................... 77
Tabel 4.9 Hasil pengukuran frekuensi Responden ................................... 78
Tabel 4.10 Hasil Uji Friedman Informasi anatomi keseluruhan variasi TI .... 79
Tabel 4.11 Hasil Uji Friedman per Anatomi ................................................ 79
Tabel 4.12 Hasil Uji Wilcoxon Informasi anatomi keseluruhan variasi Time
Inversion (TI) ............................................................................. 81
Tabel 4.13 Hasil mean rank uji Friedman informasi anatomi keseluruhan
anatomi dengan variasi Time Inversion (TI)............................... 82

viii
 ANALISA PENGARUH VARIASI TIME INVERSION (TI) TERHADAP
KUALITAS CITRA DAN PERBEDAAN INFORMASI ANATOMI MRI CERVICAL
SAGITAL SEKUEN TURBO INVERSION RECOVERY MAGNITUDE (TIRM)
Muhammad Ilham Santoso 1), Darmini 2), Siti Daryati3)
Magnetic Resonance Imaging (MRI) adalah suatu teknik pencitraan paling
maju pada saat ini. Turbo Inversion Recovery Magnitude (TIRM) merupakan salah
satu variasi dari STIR yang disebut juga dengan Turbo STIR. Time lnversion
adalah pengontrol kontras yang utama pada Inversion Recovery khususnya pada
sekuen Inversion Recovery seperti STIR. Menurut Moeller (2003) Nilai TI optimal
adalah 140 ms, Sedangkan menurut Westbrook (2011) Rentang TI Sekuen TIRM
100-175 ms, dan pengaturan TI maksimal untuk sekuen TIRM / STIR menurut
Diehl (2002) adalah 200 ms.
Tujuan Penelitian ini adalah untuk mengetahui seberapa besar pengaruh
variasi nilai TI terhadap kualitas citra dan perbedaan informasi anatomi. penelitian
kuantitatif dengan pendekatan eksperimen. Subjek penelitian Penelitian ini
dilakukan pada 8 probandus dengan 4 variasi nilai Time lnversion (TI) yaitu 10ms,
140ms, 170ms, dan 200ms. Data SNR dan CNR akan diuji dengan menggunakan
Shapiro Wilk untuk mengetahui normalitas data, dilanjutkan dengan uji regresi
linier Hasil pembacaan oleh responden ini akan di uji secara non parametrik. untuk
menilai persamaan presepsi antar responden dilakukan uji Cohen’s Kappa
kemudian dilanjutkan dengan uji Friedman dan Wilcoxon untuk melihat perbedaan
informasi anatomi.
Dari hasil penelitian kualitas citra (SNR dan CNR) terdapat pengaruh
signifikan antara variasi Time Inversion (TI) sebesar 31.6% terhadap SNR dan
48.7% terhadap CNR. Hasil uji wilcoxon antara variasi 100-140ms dan 170-200ms
memiliki beda yang signifikan, Sedangkan antara variasi TI 140-170ms tidak
terdapat beda yang signifikan. Hasil keseluruhan uji Friedman dapat diketahui ada
perbedaan informasi anatomi secara keseluruhan irisan sagital sekuen TIRM
dengan Variasi TI pada MRI Cervical potongan sagital.
Kata Kunci : MRI, STIR, TIRM, TI, SNR, CNR
Keterangan :
1)
Mahasiswa Diploma IV Teknik Radiologi
2) 3)
Dosen Jurusan Teknik Radiodiagnostik dan Radioterapi Semarang

ix
ANALYSIS OF EFFECT OF TIME INVERSION (TI) VARIATIONS TO QUALITY
IMAGE AND DIFFERENCES OF ANATOMY INFORMATION MRI CERVICAL
SAGITAL SEKUEN TURBO INVERSION RECOVERY MAGNITUDE (TIRM)
Muhammad Ilham Santoso 1), Darmini 2), Siti Daryati3)
Magnetic resonance imaging (MRI) is the most advanced imaging
technique at present. Turbo Inversion Recovery Magnitude (TIRM) is one of the
variations of STIR also called Turbo STIR. Time lnversion is a major contrast
controller in Inversion Recovery especially in Inversion Recovery sequences such
as STIR. According to Moeller (2003) the optimal TI value is 140 ms, whereas
according to Westbrook (2011) TI Range TIRM Sequences 100-175 ms, and the
maximum TI setting for TIRM / STIR sequences according to Diehl (2002) is 200
ms.
The purpose of this research is to find out how big is influence of variation
of TI value to image quality and difference of anatomical information. Quantitative
research with experimental approach. Research subjects The study was
conducted on 8 probandus with 4 variations of Time lnversion (TI) value ie 10ms,
140ms, 170ms, and 200ms. SNR and CNR data will be tested by using Shapiro
Wilk to know the normality of data, followed by linear regression test The result of
reading by this respondent will be tested non parametric. to assess the perception
equation among respondents tested Cohen's Kappa then followed by Friedman
and Wilcoxon test to see the difference of anatomical information.
From the result of image quality research (SNR and CNR) there is
significant influence between Time Inversion (TI) variation of 31.6% to SNR and
48.7% to CNR. Wilcoxon test results between variations 100-140ms and 170-
200ms have a significant difference, While between the variation of IT 140-170ms
there is no significant difference. The overall result of the Friedman test can be
seen that there is a difference in anatomical information as a whole of the TIRM
sequence sagittal slice with the TI variation on the Cervical MRI of the sagittal slice.
Keywords : MRI, STIR, TIRM, CERVICAL, SAGITAL, TI, SNR, CNR
Information :
1)
Student Diploma IV Radiology Engineering
2) 3)
Lecturer of Department of Radiodiagnostic and Radiotherapy Semarang