bimbingan ultrasonography tory
TRANSCRIPT
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MODUL ULTRASONOGRAFI
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ULTR
ASON
OGR
AFI
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Tujuan Umum
Mengetahui prinsip dasar alat USG
Gambaran USG dari keadaan
patlgis ! "lesistitis akut
"lelithiasis
Ne#rlithiasis
$esiklithiasis
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Tujuan "husus
Gambaran USG dari klesistitis akut%klelithiasis% ne#rlithiasis% dan&esiklithiasis'
(at)silgi terjadin*a gambaranUSG pada kelainan tersebut
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Intrdu+tin
Suara ultra adalah suatu bentukenergi berupa gelmbang suara
Frekuensi tinggi melebihi ,-'---.ert/'
Suara ini berada di luar kemampuanpendengaran manusia'
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0hara+teristi+ # US 1a&e
Sl1l* transmitted in air substan+e
Fastl* transmitted in slid substan+e
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Nt use#ul t e2amine
3ne
Air +ntaining rgan
Organ l+ated behind the bne andair4gass
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3asi+ (h*si+
Fre5uen+* ! Number # +*+le 4 se+
$el+it* ! transmissin speed Re&erse prprtin ! Fre5 ! Length #
1a&e 67
Diagnsti+ ! 898- M./ ,%: ; 8-M./
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3asi+ (rin+iple # US
3ased n (ie/ ele+tri+ =>e+t
=le+tri+al energ* Sund 4 Me+hani+al=nerg* 6&i+e &ersa7
0r*stal ?uart/ is l+ated in transdu+er
=le+tri+ 4 Shrt <age pulse $ibrating # the+r*stal 0reating a pulse sund rgan 0r*stal =le+tri+ energ* ImageIn#rmatin
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Instrument +nsist #
Transmitter @ re+ei&er
=+h pr+essr 0athde ra* tube Mnitr
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(rinsip Dasar Alat USG
Alat peman+ar dan penerima gema'
Alat pen*impan dan penglah gema
Alat peraga gambar
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Trandu+er4(rbe
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(rbes
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"e*pad 0ntrl
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Mnitr
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Attenuatin
Attenuatin # US transmissin 1ithinrgan due t !
8' ReBe+tin
,' Absrptin
C' S+attering ! the si/e # the
reBe+tr in rgan 1hi+h is rea+hedthe US is shrter than the1a&elength # US
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Attenuatin
The attenuatin in+rease 1ith the in+reasing ##re5uen+*
TG0 ! +ntrlling # attenuatin
=+h # the li&er ! Is used as standard e+h
ise+hi+
.*pe+hi+ ! +rte2 # the kidne*
.*per e+hi+ ! pan+reas% bne
Ane+hi+h 4 sn lu+ent 4 e+h #ree ! gallbladder% urinar* bladder% rgan +ntains #1ater
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0upling
0upling ! Intermediate substan+e
8' T eliminate the air bet1eentransdu+er and skin
,' T +n#rm the irregularit* # theskin sur#a+e
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0upling
It has transmissin &el+it* # US issimilar t s#t tissue 68:- m4 se+7
0upling
Oil
Eell*
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T*pe # transdu+er
L1 #re5uen+*
6,%: ;C%: M./7
(enetratin is higher Reslutin is mderate
Deep rgan
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T*pe # transdu+er
.igh #re5uen+*
%: ; 8- M./
(enetratin is l1 Reslutin is gd
Sur#a+e rgan
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Arti#a+t
Arti#a+t ! Is an* e+h signal 1hsedispla*ed psitin des nt+rrespnd t the psitin # a
reBe+tr in the bd*
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Arti#a+t
T*pe # arti#a+t
8' (sterir a+usti+ shad1
,' (sterir enhan+ementC' Re&erberatin
Sund pulse reBe+ting ba+k and
#rth bet1een highl* reBe+ti&esur#a+e is displa*ed as anparallel # e+h
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0lini+al appli+atin
8' Fasting 9H hurs
,' Fasting # smking 4 talking
C' Drink large amunt # 1ater
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US Ad&antages
8' Nn in&asi&e
,' Nn traumati+
C' N spe+ial preparatin' =asier and #aster
:' .igh a++ura+* @ high diagnsti+
&alue
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US disad&antages
Unable t e2amine air )lled rgan
Unable t e2amine bne 4 rganbehind it
2amp e a nrma t es
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2amp e a nrma t es1hi+h +an be e2amined b*
US
8' 0*st
,' Abs+ess
C' Tumr' Stnes
:' .epati+ +irrhsis
' As+ites
' (leural e>usin
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Longitudinal section of normal
Right lobe of lier
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Longitudinal section
through midline of left
lobe
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Normal !ancreas
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"idne#
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"lesistitis Akut
(eradangan *ang terjadi padakantung empedu
=TIOLOGI
9 3atu
9 3akteri
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(at)slgi
687 peradangan mekanis
6,7 peradangan kimia1i
6C7 peradangan bakteri
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Gambaran USG
(embesaran kantung empedudengan dinding *ang menebalmen+apai H98- mm%
Gambaran berlapis dua terdiri dari ,lapis hiperekhik *ang dibatasi lehdaerah *ang bebas ekh
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Acute $holec#stitis
Gallbladder ultrasound demonstrating a diffusel# thic%ened
gallbladder &all' a small amount of (ericholec#stic fluid' and an
im(acted gallstone in the nec% of the gallbladder
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"lelithiasis
(=NG=RTIAN
3atu *ang terdapat pada kantungempedu
=TIOLOGI
"egemukan% diet tinggi kalri% bat
6kl)brat7
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(at)slgi
Mekanisme penting dalampembentukan empedu litgenikklesterl6pembentuk batu7
(eningkatan sekresi empedu% Gangguan kn&ersi klesterl menjadi
asam empedu%
(enurunan sekresi garam9garam empedu
dan #s#lipid leh hati' "ejenuhan klesterl dalam empedu
sehingga menimbulkan endapan'
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Gambaran USG
"antung empedu dapat terisi penuhdengan batu 6sliter% multipel7'
3atu pada kantung empedu akanterlihat sebagai massa *anghiperekhik sebagai tanda langsungdan timbuln*a ba*angan akustik
diba1ahn*a sebagai tanda tidaklangsung'
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Gallbladder
Stone
Acoustic
shado&ing
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Ne#rlithiasis
(=NG=RTIAN
3atu *ang terdapat pada pel&kalisesginjal
=TIOLOGIUrlithiasis dapat disebabkan lehbeberapa keadaan diantaran*a Sindrma tubular renal
Gangguan en/imatik
"eadaan hiperkalsemia
Asam urat
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Gambaran USG
Tunggal atau multiple'
Terlihat sebagai suatu massahiperekhik di daerah sinus ginjal 6pada
kaliks atau pielum ginjal7' 3atu *ang +ukup besar J :mm
umumn*a disertai dengan ba*anganakustik di psterirn*a'
3atu Kstaghrn dapat terlihatmen*erupai kelmpkan batu9batumultiple'
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Staghorn calculus
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N=(.ROLIT.IASIS 9ULTRASOUND
Stne Stnes Stne
A+usti+ shad1
A+usti+ shad1
Nn bstru+ting stne Multiple l1er ple and renal pel&i+stnes 1ith ass+iated mild
h*drnephrsis'
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$esiklithiasis
(=NG=RTIAN
3atu *ang terdapat pada kantungkemih
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Gambaran USG
3atu akan terlihat sebagai suatumassa hiperekhik padat % bentukbulat atau lnjng *ang bila +ukup
besar umumn*a disertai denganba*angan akustik di psterirn*a'
3atu dalam lumen dapat berpindah9
pindah bila penderita berubah psisi1aktu pemeriksaan'
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Acute he(atitis
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$hronic he(atitis and cirrhosis
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Abscess
!osterior
enhancement
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$hronic (ancreatitis
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Tumor of head (ancreas
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