Ultrasonografi

(USG)

Merupakan salah satu pencitraan diagnostik untuk pemeriksaan

organ-organ tubuh

Dapat mempelajari: bentuk, ukuran anatomis, gerakan dan

hubungan dengan jaringan sekitarnya

Keunggulan pemeriksaan ini;

Mudah, cepat dan tepat
Tidak invasif Non traumatik

Tanpa persiapan yang sulit

 Memberikan informasi yang akurat

Tidak ada efek samping

Terjangkau oleh masyarakat namun tetap dalam kombinasi terpilihnya dengan alat diagnostik lain

Sejarah:
Penemu I 1952; Howry & Bliss Scanner Diagnostic 1976; Taylor & Mc Cready

Teknik Gray Scale

Penggunaan USG disesuaikan dengan bentuk lapangan dan

terarah pada golongan umur

 Prinsip

USG:

Gelombang

suara

dengan

frequensi tinggi melewati ambang daya tangkap telinga manusia sehingga tidak terdengar oleh manusia

Energi Sonic yang dipakai ; 1-10 Mhz (1-10

juta cps) energi yang terdengar oleh manusia 30
n 20.000 Hz perdetik (cps)

Gelombang suara frequensi tinggidihasilkan dari

kristal-kristal
(transducer)

yang

terdapat

dalam

alat

 Sifat energi sonic : Lambat medium gas

Sangat cepat medium padat

Masing-masing jaringan mempunyai impedance

akustic tertentu;
Anechoic Hipoechoic Hyperechoic

Persiapan;

Puasa abdomen atas Buli-buli penuh pelvis dan gynecologis

 Organ yang dapat diperiksa;

Traktus billiaris, Hepar, Lien, Pankreas, ginjal, vaskuler/kgb, Payudara, Kelenjar tiroid, Testis, vesica urinaria, Prostat

Tomografi Computer
Computerized Tomography Scanning

(CT Scan)

Diperkenalkan pada tahun 1972 Prinsip kerja ;

Tabung menyinari pasien Detektor menagkap sinar X Diolah oleh computer Layar monitor

 Konstruksi I Hounsfield CT Scan ada 4 generasi ;

Sekarang detektor >>

Tabung yang bergerak

Pasien diam

Tabung+ detektor Gantry

Teknik Pemeriksaan
Tahap I Buat sanogram (topografi) untuk program potongan mana yang akan dibuat

Tahap II

Buat scan sesuai dengan yang

telah diprogram pada tahap I

Hasil scan diolah sehingga bagus dan jelas

CT Scan modalitas yang sangat membantu ahli

saraf dan bedah

Dapat untuk pemeriksaan; kepala, leher,

thorax, abdomen, pelvis dan ekstremitas

Cukup mahal tidak semua rumah sakit punya Nilai akurasi tinggi Dibutuhkan ketenangan pasien waktu diperiksa

 Gambaran lesi; isodens, hipodens, hiperdens Pemeriksaan; tanpa kontras dan dengan
kontras

Tebal irisan; sesuai dengan organ yang

diperiksa dan tergantung besar dan bentuk

kelainannya

Magnetic Resonance Imaging

(MRI)

Suatu teknik pemeriksaan/pencitraan dengan

prinsip Resonansi Magnetic Inti Atom

Mulai thn 1977 1980 banyak dipakai Prinsip dasar MRI

Tubuh (inti atom H) medan magnet diransang oleh suatu sinyal radio frequensi (RF) atom H beresonansi menyerap sebagian energi dari sinyal RF tersebut.

Sinyal RF distop embali energi

atom H akan melepaskan

Dengan cara mengeluarkan sinyal RF sinyal

ditangkap oleh antena khusus komputer

diolah dan direkonstruksi suatu citra (berdasarkan kerapatan atom H dalam tubuh)

Jadi; Konsentrasi proton hidrogen tinggi

gambar putih, rendah gambar hitam

Alat MRI terdiri dari;

Magnet dengan kekuatan 0,064 1,5 T Coil, alat pemancar dan penerima RF tinggi

 Sistem komputer canggih

Kekuatan magnet MRI dibagi;

High field magnet 1 1,5 tesla

Middle field magnet 0,5 1 tesla

Low field magnet < 0,5 tesla

Keunggulan MRI
Sangat sensitif menilai jaringan lunak Mampu menghasilkan penampang dalam

berbagai arah tanpa merubah posisi pasien (multi planar) axial, koronal, sagital

 Tidak menggunakan radiasi Dapat membedakan antara jaringan lunak, lemak dan cairan

Tidak invasif

Kontras yang digunakan Gadolinium DTPA (Gd

DTPA)

Tindakan pengamanan pasien;

Memakai alat pacu jantung KI

Memakai protese (metal) KI

Kehamilan Trimester I KI

 Penyakit jantung dan epilepsi awasi Jaringan memakai alat-alat metal/besi Pasien Klaustrofobia

Sediakan obat-obat untuk keadaan darurat

CT SCAN

Computed Tomography (CT or CAT scan) equipment

CAT Scan (CT) - Head

Normal head CAT scan with intravenous contrast.

ORAL CAVITY

Axial CT scans

Coronal CT scan

TRACHEA

Normal trachea. CT scan shows normal trachea. The tracheal wall is seen
as a soft tissue stripe measuring 1-2 mm in thickness. The anterior and lateral walls are formed by horseshoeshaped cartilaginous rings, which frequently calcify with age. The posterior wall consists of a fibromuscular membrane.

THORAX

CT angiogram. Frontal or coronal view of chest-3D slab image showing pulmonary vessels.

 Maximum intensity projection reconstruction. Cross-sectional contrast-enhanced CT scan shows the main

(MPA), right (RPA), and left (LPA) pulmonary arteries and the ascending (AA) and the descending (DA) thoracic aorta. B, Maximum intensity projection images in the transverse plane and in the coronal plane better show the branching pattern of the central pulmonary arteries and their relationship to the adjacent structures.

CT of the lungs, window level set to demonstrate the vessels and air ways - not intended to demonstrate the heart, spine muscles etc. This is used to look for things like pneumonia or lung cancer.

ABDOMINAL AND PELVIC CT

CT slice through the mid-abdomen showing multiple normalappearing organs, which are labeled.

PANKREAS

Normal pancreas on CT. Due to the oblique line of the pancreas. The entire organ is seldom seen on a single image.

APPENDICITIS

Appendicitis: The appendix (A) is distended and inflamed. In this patient the appendix has not yet ruptured.

KIDNEY AND URETER

3D reconstructed CT view of the kidneys and ureters, which connect the kidneys to the bladder. Part of the ribs, spine and pelvis are included in this image.

CAT Scan (Children)

Normal CT of the abdomen. A CT 'slice' through the upper abdomen of a child illustrates the normal appearance of both kidneys, the liver and gallbladder.

Normal CT scan of the chest of a 9-year-old boy. A CT 'slice' through the chest shows normal black appearance of the lungs. The normal heart is also seen as the round structure near the top of the chest in this image.

ELBOW

CT series obtained with 64-slice multidetector CT. Axial section through the olecranon and trochlea.

VERTEBRAE

CT, coronal reconstruction of the lumbar spine documenting a metastatic lesion at L1

KNEE

Sagittal reconstructed CT image shows intra-articular contrast (I) and inadvertent injection of contrast in prepatellar bursa (arrow).

WRIST CT

CT SCAN PANGGUL

HIP

CT arthrography. Coronal multiplanar reformatted (MPR) image.

MRI

Magnetic Resonance Imaging (MRI) equipment A

T1 IMAGING

BRAIN MRI SAGITTAL T1

This T1 weighted MR image Corpus of the brain shows cortex with white and grey matter, corpus callosum, lateral ventricle, thalamus, pons and cerebellum.

BRAIN MRI TRANSVERSAL

This T1 weighted MR image of the brain shows eyeballs with optic nerve, medulla, vermis, and temporal lobes with hippocampal regions.

MRI ORBITA T1
T1 weighted MRI scan through the eyballs, optic nerves and extraocular muscles.

MRI ORBITA T1 WITH CONTRAST

T1 weighted contrast enhanced MRI scan through the eyballs, optic nerves and extraocular muscles.

SHOULDER AXIAL T1
Axial T1 weighted shoulder MR image, showing humeral head, glenoid, anterior labrum, posterior labrum and biceps tendon.

SHOULDER CORONAL T1
Coronal oblique angulated T1 weighted shoulder MR image showing acromion, humeral head, glenoid and supraspinatus tendon.

BREAST MRI IMAGES T1 PRE CONTRAST

T1 weighted MR image of the breasts.

BREAST MRI IMAGES T1 POST CONTRAST

T1 weighted MR image of both breasts with contrast.

ANATOMIC IMAGING OF THE LUNGS

NORMAL LUNG PERFUSION MRI

MVP PARASTERNAL
Cardiac mitral valve prolapse (MVP) in vertical long axis view (VLA).

MRI UPPER ABDOMEN T1 WITH CONTRAST

T1 weighted MR image with contrast, showing liver, portal vein, kidneys, spleen, stomach and pancreas.

MRI Liver

LUMBAR SPINE T1 SE SAGITTAL

T1 spin echo image of the lumbar spine with parts of thoracic spine, spinal cord and sacrum in sagittal view.

NORMAL FETUS
Fetus (Brain) and Dermoid in Mother Sagittal view

KNEE MRI CORONAL T1

This MR image of the knee shows femur, tibia, fibula, intracondylar notch and menisci with one menical tear.

KNEE MRI SAGITTAL T1

This MR image of the knee shows femur, tibia and menical tear of the posterior horn of the medial meniscus.

MRI T2 WEIGHTED

BRAIN AXIAL
demonstrating the inferior frontal lobe and temporal lobe and occipital lobe and cerebral peduncle and substantia nigra and red nucleus and aqueduct of Sylvius and frontal sinus and orbit.

This T2 weighted MR image of the head shows maxillary sinus, nasal septum, clivus, inner ear, medulla, and cerebellum.

This T2 weighted MR image of the brain shows eyeballs with optic nerve, medulla, vermis, and temporal lobes with hippocampal regions.

This T2 weighted MR image of the brain shows cortex, lateral ventricle, and falx cerebri

These are MRI T2 weighted sagittal images of my head after a 20cc gadolinium injection used for contrast. Notice a moderate amount of ectopic cerebellar tonsilar tissue hanging below the foramen magnum and actually indenting the medulla to a minimal degree.

LUMBAL

LUMBAL SPINE AXIAL

Axial T2 fast spin echo image of the lumbar spine in line of the kidneys

LUMBAL SPINE SAGITAL

T2 fast spin echo image of the lumbar spine with parts of thoracic spine, spinal cord and sacrum in sagittal view.

CHEST

ABDOMEN

This T2 weighted slice shows liver, spleen, aorta, vena cava, stomach, and thoracic vertebra.

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