Johanes C. Mose

Dept. Obstet Gynecol Faculty of MedicineUniversitas Padjadjaran BandungULTRASONOGRAPHY : PAST, PRESENT AND FUTURE

Sejarah berdirinya PUSKIPengiriman SDM ke Kobe University Jepang : 1970-19711977 : Alat USG bistabel di bandung (Dr. Suyono Hadi, Bgn. Penyakit Dalam RSHS)1977 : Ekokardiografi di bgn Kardiologi FKUI/ RSCM Jakarta

3 April 1982 diadakan rapat untuk membentuk organisasi yang menampung peminat pengguna alat USG di hotel Borobudur Jakarta.Dibentuklah organisasi PUSKI dengan susunan kepengurusan pertama : - Penasehat : Dr. Sujono Hadi - Ketua : Prof. Dr. Gani Ilyas - Sekretaris : Dr. Azwar Boer - Bendahara : Dr. Sugiarto - Anggota : Dr. willyarto S. Wibisono

POGIThn 1990an pada stiap tahun bersamaan dengan penyelenggaraan PIT/Kongres selalu mengadakan Kursus USG Dasar kemudian diikuti dengan USG AdvanceThn 2000 Kursus USG dengan Akreditasi AOFOG pertama di Bandung, bersamaan dengan PIT HKFM PertamaThn 2007 Kursus USG dengan Akreditasi ISUOG pertama di Jogyakarta.

ISUOG APPROVED USG COURSE IN INDONESIAI : 2007, JogyakartaII : 2008, BandungIII : 2009, SemarangIV : 2010, BaliV : 2011, SurabayaVI : 2012, MedanVII: 2013, ???

INSTRUMENTATIONEarly stage of diagnostic ultrasound :

We call it : Contact compound ultrasound scannerEven they already equipped with Doppler and color but they still occupied by CW technology

At that time there was not Pulse Wave doppler exist in the market yet

3D & 4D probes Austria Made Korea made USA made 450 gram 400 gram 375 gram

Made in China 2010, Less than 250 gram ?

*Powerful 2D Image QualityDramatically reduceArtifacts & Clutter

*2Mhz4MhzBasic Harmonic ImagingEnhanced spatial resolution & contrastClearer images in mid-field-center portionAdvantageFor elder patient &fat patientIgnoring original transmitted signal and receiving 4Mhz signal.Bi-directional Harmonic Imaging

*Powerful 2D Image Quality

Fundamental ImagingHarmonic Imaging Good Spatial Resolution Good Contrast Resolution Main Features of Harmonic Imaging

Contrast Harmonic Imaging*To overcome vessel visualization of color DopplerCrossover of ultrasound, CT and MRITo detect and characterize liver lesion better than CT/ MRIUser can adjust flash timer (Timer1,2,3) & flash trigger (1,2,5,10 sec)

*Color & B&W real time Ultrasoundfrom one Brand cause of different channels

EARLY PREGNANCY

CONGENITAL ANOMALIES

Vasa Anastomosis

Septostomy

INVASIVE PRENATAL DIAGNOSISAMNIOCENTESIS

Transabdominal CVS

TRANSVAGINAL CVS

Fetal Blood Sampling

IUFT

Drainage techniques Needle aspiration

Empty !EARLY PREGNANCY COMPLICATIONMissed abortionBlighted Ovum

Ectopic pregnancy

Molar pregnancy

FETAL BIOMETRY

OBSTETRICAL COMPLICATIONPREMATURE LABOUR

PLACENTA PREVIAABRUPTIO PLACENTA

MULTIPLEPREGNANCYOMPHALOPHAGUS

DOPPLER TECHNIQUE

FETAL ECHOCARDIOGRAPHY

SHORT AXIS VIEW

3D & LIVE 3D

Filly R. Ultrasound: The stethoscope of the future. Radiology 1988;167:400

From Note book to stetoscope ?

**Conventional harmonic imaging transmits and receives same signal at same time. Bi-directional harmonic imaging receives two times the original signal, which finally delivers enhanced spatial resolution and contrast. Bi-directional harmonic imaging especially realizes better images in mid-field center portion. **Harmonic imaging is a higher frequency than the fundamental frequency and has a narrower range of the main lobe with better spatial resolution. In addition, the harmonic frequency has little influence on the side lobe that it provides the improvement on the contrast resolution.