pemeriksaan radiologi thorax
DESCRIPTION
medicine, bedahTRANSCRIPT
![Page 1: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/1.jpg)
Raymond Adiwicaksana
![Page 2: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/2.jpg)
Chest X-Ray CT-scan USG
![Page 3: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/3.jpg)
![Page 4: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/4.jpg)
Foto PA Foto AP Foto lateral kiri Posisi lain
◦ Top lordotic◦ Recumbency◦ Oblique◦ Lateral decubitus◦ Expirasi maksimal
![Page 5: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/5.jpg)
![Page 6: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/6.jpg)
• Faktor kondisi– Kondisi pulmo– Kondisi costae
• Faktor inspirasi cukup– Cukupo– Kurang
• Posisi sesuai– Errect– supine
• Simetris
![Page 7: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/7.jpg)
1. pulmo 2. hilum 3.jantung 4.mediastinum 5. diafragma 6. sudut costofrenik 7. trakea 8. tulang 9.jaringan lunak 10. area dibawah diafragma
![Page 8: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/8.jpg)
Untuk mengukur jantung Mendeteksi pembesaran jantung CTR adalah perbandingan diameter
transversal jantung dengan diameter transversal rongga thorax
Ratio normal◦ 50%, untuk asia 55%◦ 60% pada neonatus
![Page 9: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/9.jpg)
Kelemahan◦ Tidak bisa dipakai pada orang dengan letak
jantung mendatar atau vertikal◦ Orang dengan pericardium penuh lemak
Rumus◦ CTR = (a+b)/(c1+c2)
![Page 10: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/10.jpg)
![Page 11: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/11.jpg)
![Page 12: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/12.jpg)
![Page 13: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/13.jpg)
![Page 14: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/14.jpg)
![Page 15: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/15.jpg)
![Page 16: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/16.jpg)
![Page 17: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/17.jpg)
A chest computed tomography (to-MOG-ra-fee) scan, or chest CT scan, is a painless, noninvasive test. It creates precise pictures of the structures in your chest, such as your lungs. "Noninvasive" means that no surgery is done and no instruments are inserted into your body.
![Page 18: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/18.jpg)
Lung imaging test Computed axial tomography (CAT) scan Helical CT scan (another name for spiral CT
scan)
![Page 19: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/19.jpg)
The chest CT scan can: Provide more detailed pictures of your lungs
and other chest structures than a standard chest x ray
Find the exact location of a tumor or other problem
Show something that isn't visible on a chest x ray
![Page 20: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/20.jpg)
![Page 21: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/21.jpg)
![Page 22: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/22.jpg)
Indikasi◦ Emboli paru◦ Emfisema◦ Hipertensi pulmonal◦ Ca paru◦ Sesak nafas dan sakit dada yang tidak diketahui
sebabnya Pemeriksaan ini tidak spesifik Kontraindikasi
Hipoksia berat dan kelainan jantung bawaan
![Page 23: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/23.jpg)
Isotop99m Tc makrokoloid sebesar 2mCi intravena, memancarkan sinar gamma dengan energi 140keV
Tidak perlu persiapan Pemeriksaan
◦Siapkan preparat radiofarmaka◦Suntikkan perlahan sementara penderita ispirasi beberapa kali dalam posisi tidur terlentang◦Scanning paru dengan kamera gamma pada empat posisi depan, belakang, sisi kanan, dan kiri
![Page 24: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/24.jpg)
Interpretasi◦ Myocardial perfusion imaging (MPI) offers a
method of visualizing blood flow to the heart by injection of a radioactive cardiac-specific tracer, ie, a cardiac imaging isotope. This improves the diagnostic accuracy of a cardiovascular stress test
◦ MPI offers the additional advantage of estimating left ventricular function.
![Page 25: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/25.jpg)
Find the cause of unexplained chest pain or chest pain brought on by exercise.
Check for the location and amount of damage caused by a heart attack.
Identify coronary artery disease (CAD). Check to see that the heart is getting
enough blood after heart surgery or angioplasty.
Identify a congenital heart defect
![Page 26: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/26.jpg)
1.Calcium-score screening heart scan2.Coronary CT angiography (CTA)3.Total body CT scan
![Page 27: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/27.jpg)
Reasons for the procedure A chest ultrasound may used to assess
◦ the presence of excess fluid in the pleural space or other areas of the chest, especially when the amount of fluid is small.
◦ useful to determine the type of fluid, exudate (seen in inflammatory, cancerous, or infectious conditions) or transudate (fluid that has leaked from blood or lymph vessels for various reasons).
◦ It can also be used to evaluate the heart and its valves. When used for this purpose, the procedure is called an echocardiogram.
Chest ultrasound may be performed to guide a needle during thoracentesis (puncture of the chest wall for the removal of fluids) or biopsy.
to assess the movement of the diaphragm.
- john hopkins hospital -
![Page 28: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/28.jpg)
absence of radiation, better portability, real-time imaging, the ability to perform dynamic imaging.
![Page 29: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/29.jpg)
Ultrasound examination of the pleura is more sensitive than a plain chest radiograph at detecting the presence of pleural fluid and differentiating pleural fluid from lung consolidation. Compared with computed tomography (CT), pleural ultrasound has a 95 percent sensitivity for detection of pleural disease in patients with a “white out” on plain chest radiograph, but is slightly less sensitive in detecting small amounts of fluid
![Page 30: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/30.jpg)
— Thoracic ultrasound is an operator dependent technology.
Ultrasound is not as good as CT imaging for evaluation of the underlying lung parenchyma in the setting of complex pleural and lung parenchymal disease. Ultrasound guidance is not as good as guidance by CT imaging for complicated interventional procedures, such as empyema drainage with a pigtail catheter or biopsy of pleural masses.
![Page 31: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/31.jpg)
Bedside detection of pleural fluid when the plain chest radiograph shows a “white out”
Bedside detection of a pneumothorax Guidance for diagnostic and therapeutic
thoracentesis Guidance for placement of thoracostomy
tubes
![Page 32: Pemeriksaan Radiologi Thorax](https://reader033.vdocuments.mx/reader033/viewer/2022061112/545a9a9daf79594e128b5678/html5/thumbnails/32.jpg)
There are many clinical indications for TUS but the most common is pleural effusion assessment.
TUS can diagnose inoperable pleural metastases,
allow safe day case pleural intervention, exclude significant pleural pathology not visible on CXR, triage further investigation.
- British Medical journal-