Kuliah 4 - GI Imaging Kls 2 RIM
-
Upload
makmunnawil -
Category
Documents
-
view
232 -
download
0
description
Transcript of Kuliah 4 - GI Imaging Kls 2 RIM
![Page 1: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/1.jpg)
GastrointestiGastrointesti nal nal
ImagingImaging
Rima ZakiyahRima ZakiyahPSPD FK UNISMAPSPD FK UNISMA
![Page 2: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/2.jpg)
Bismillah...
![Page 3: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/3.jpg)
CONVENTIONAL X-RAY FILMS
1-INTRA-ORAL FILMS
2-EXTRA-ORAL FILMS- Panoramic
![Page 4: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/4.jpg)
TYPES OF INTRA-ORAL FILMS
1-PERIAPICAL FILMS
For children&adults with small mouth, anterior teeth in adults, and standard film for anterior&posterior teeth in adults
2-BITEWING FILMS
For posterior teeth in children, young children, adults(most frequent film) and premolar or molar region
3-OCCLUSAL FILMS
To show large areas of upper or lower jaw
![Page 5: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/5.jpg)
![Page 6: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/6.jpg)
EXTRA-ORAL FILMS
INDICATIONS: 1-Px unable to open mouth2-view large area of pathology3-general view of mandible or maxilla4-view more bones of the face(skull or sinuses)5-impacted or unerupted teeth6-fractures of jaws & localization of foreign bodies7-TM joint
![Page 7: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/7.jpg)
PANORAMIC
![Page 8: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/8.jpg)
![Page 9: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/9.jpg)
9
Pemeriksaan radiologi pada abdomen meliputi :
1. Radiologi konvensional :
a. Plain photo abdomen tanpa persiapan
(BOF = Buiek Oversich Film)
b. Plain photo abdomen dengan persiapan
(BNO = Buiek Nier Oversich, / KUB =
Kidney Urinary Bladder)
![Page 10: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/10.jpg)
• Pemeriksaan bisa dengan :• • Foto Polos
•
• BOF foto BNO foto • ( tanpa persiapan ) ( dengan persiapan )
Cara Persiapan pemeriksaan Foto BNO :1. 1 – 2 hari pre X-foto, pasien diberi makan bubur kecap (low residual meal).2. Malam hari diberi laksan, minum 3 – 4 gelas air putih3. Subuh pasien akan diarrhea4. Pagi tidak boleh makan, minum, bicara, tertawa, merokok5. Pasien kemudian di foto
![Page 11: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/11.jpg)
PEMERIKSAAN FOTO POLOS ABDOMEN
![Page 12: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/12.jpg)
FOTO POLOS ABDOMEN
![Page 13: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/13.jpg)
![Page 14: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/14.jpg)
Compare
Haustra
Large bowel
Valvulae conniventes
Small bowel
![Page 15: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/15.jpg)
Know What You’re Looking For
Supine – Double Bowel Wall Sign
PNEUMOPERITONEUM
Outlining of liver/GB
![Page 16: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/16.jpg)
Harus diperhatikan pada BNO
• 1. Bagaimana distribusi gas dalam usus. normal gas dalam gaster, duodenum, colon ( caecum sampai rectum )
• 2. Bagaimana gambaran hepar dan lien.• 3. Bagaimana gambaran/ bayangan kedua ginjal
apakah ada bayangan (batu) radiopaqe disepanjang UG tract
• 4. Gambaran psoas line/ psoas shadow.• 5. Bagaimana keadaan tulang-tulang.• 6. Bagaimana keadaan flank area.
![Page 17: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/17.jpg)
Barium Studies
• (Video) Esophagogram• Barium Swallow• UGI series
![Page 18: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/18.jpg)
ESOPHAGUS
![Page 19: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/19.jpg)
Esophagogram or Barium Swallow
• Evaluates pharynx and esophagus
• Limited evaluation of stomach
• Double or Single Contrast
• Mucosal contour and Motility
![Page 20: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/20.jpg)
Identify gastro esophageal junction.
Describe the course of Esophagus
Locate the starting point of Esophagus
![Page 21: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/21.jpg)
What are the normal impressions in the Esophagus?
What are the normal sites of narrowing of Esophagus?
![Page 22: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/22.jpg)
OESOPHAGUS
Penyempitan yang normal:•Sekitar Cartilago cricoid•Persilangan Arcus Aorta dan Bronchus kiri •Sebelum masuk diaphragma
Gambaran normal dari mukosa :
– Biasanya lurus, parallel, tipis– Uniform
![Page 23: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/23.jpg)
![Page 24: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/24.jpg)
![Page 25: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/25.jpg)
Body Habitus - Effect On Positioning• Hypersthenic
– Horizontal and superior– Dependent portion above umbilicus
• Asthenic– Vertical and inferior
• Sthenic– Generally found between xyphoid process and iliac crest
![Page 26: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/26.jpg)
Contrast media Type of contrast medi
a– Barium sulfate– Water soluble
![Page 27: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/27.jpg)
Single Contrast vs Double Contrast
• Single Contrast– Generally uses just thin Barium– Distends lumen with high density material– Easier for patient but less mucosal detail
• Double Contrast/Air Contrast– Thick barium coats lumen– Effervescent tablets ingested to distend lumen with air– Produces images with greater mucosal detail – Greater sensitivity for small lesions, polyps, ulcers
![Page 28: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/28.jpg)
SINGLE CONTRAST STUDY
![Page 29: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/29.jpg)
DOUBLE CONTRAST
STUDY
![Page 30: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/30.jpg)
![Page 31: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/31.jpg)
BARIUM SULFATE
![Page 32: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/32.jpg)
WATER SOLUBLE
CONTRAST AGENT
![Page 33: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/33.jpg)
PRINCIPLE1. Extrinsic lesion2. Intrinsic lesion
2.1 Protruded lesion mucosal fold, polyp, tumor , varices
2.2 Depressed lesion ulcer, diverticulum, perforation
![Page 34: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/34.jpg)
mucosal mass
A
submucosal or intramural mass
Bextrinsic mass
C
Diagram
![Page 35: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/35.jpg)
Extrinsic lesion
MASS
![Page 36: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/36.jpg)
![Page 37: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/37.jpg)
Protruded lesion
A B mucosal mass
![Page 38: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/38.jpg)
Polyp
A B
![Page 39: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/39.jpg)
submucosal or intramural mass
Diagram
![Page 40: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/40.jpg)
![Page 41: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/41.jpg)
![Page 42: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/42.jpg)
Depressed lesion
A
B
Singlecontrast
Doublecontrast
upright
C
-En face Profile
![Page 43: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/43.jpg)
CARCINOMA
![Page 44: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/44.jpg)
CARCINOMA 2( )
![Page 45: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/45.jpg)
![Page 46: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/46.jpg)
![Page 47: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/47.jpg)
![Page 48: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/48.jpg)
![Page 49: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/49.jpg)
Esophageal carcinoma
![Page 50: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/50.jpg)
- PSEUDO ACHALASIA caused b y direct spread to the distal eso
phagus from gastric carcinoma Radiographic findings :
1. Irregularly, narrowed an d nodular( arrowhead), so
metimes ulcerated (arrow) , lesion at distal esophagus 2 . Rapid transition betwee n normal and abnormal p
art. 3. Dilatation of proximal esoooooooo
![Page 51: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/51.jpg)
STOMACH
![Page 52: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/52.jpg)
Pemeriksaan Gaster & Duodenum
Bentuk mukosa gaster yang normal :•Bentuk mozaik di daerah fundus•Lurus-lurus (magenstrasse) di corpus•Convergeren di pylorus
Bentuk mukosa duodenum yang normal :•Halus seperti bulu ayam•Pd. Pars desc. Ada lekuk kecil=papilla Vateri•Sekitar bulbus duodindentasi vesica felea,
![Page 53: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/53.jpg)
![Page 54: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/54.jpg)
KELAINAN YANG TAMPAKKELAINAN YANG TAMPAKPADA MUKOSAPADA MUKOSA
• Filling defect :
– Bisa dari luar – sudut tumpul, atau dari dalam lumen – tajam
– Bisa massa benigna – tepi halus/ rata,
– atau maligna – tepi irreguler
Additional defect/ Shadow :
- Bayangan tambahan di luar lumen.
- Bentuk menentukan jinak/ ganas
- Ulcus atau diverticle
![Page 55: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/55.jpg)
![Page 56: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/56.jpg)
![Page 57: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/57.jpg)
Radiographic appearances of benign gastric ulcer
![Page 58: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/58.jpg)
Radiographic appearances of benign gastric ulcer
Radiation of smooth thickened folds (arrow) extending directly to the edge of the crater (arrowhead) on profile view(A) and en-face view (B)
Radiographic appearances of benign gastric ulcer
![Page 59: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/59.jpg)
Cart wheel phenomen
![Page 60: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/60.jpg)
Duodenal Ulcer
![Page 61: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/61.jpg)
Duodenal Diverticulum
stomach
bulb
![Page 62: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/62.jpg)
Gastric Diverticulum
![Page 63: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/63.jpg)
![Page 64: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/64.jpg)
Gastric cancer
Polypoid mass
- Produce filling defect (arrow) on barium study
![Page 65: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/65.jpg)
Gastric cancer
Focal constricting lesion: localized infiltrating carcinoma or localized scirrhous carcinoma
• Annular filling defect (arrow)
![Page 66: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/66.jpg)
Focal constricting lesion
: localized infiltrating
carcinoma or localized
scirrhous carcinoma
- circumferential
irregular narrowing of
the lumen with
rigidity (as figure;
involved body and
antrum)
Gastric cancer
bodyantrumbulb
fundus
![Page 67: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/67.jpg)
![Page 68: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/68.jpg)
![Page 69: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/69.jpg)
![Page 70: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/70.jpg)
Radiographic Exams
![Page 71: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/71.jpg)
COLON
![Page 72: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/72.jpg)
![Page 73: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/73.jpg)
Colonic Diverticulosis
![Page 74: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/74.jpg)
Colonic Diverticulosis
![Page 75: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/75.jpg)
![Page 76: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/76.jpg)
76
CARCINOMA COLON
• Ada 3 bentuk
1. Fungative type
2. Polypoid type
3. Annuler type
• Gambaran radiologis : adanya filling defect dan obstruksi, merupakan tanda yang terpenting secara radiologis.
![Page 77: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/77.jpg)
![Page 78: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/78.jpg)
Colonic Carcinoma
• Annular Carcinoma (green arrow) with shelf-like margin (black arrow)
![Page 79: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/79.jpg)
Polypoid Carcinoma (arrow)
Colonic Carcinoma
![Page 80: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/80.jpg)
![Page 81: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/81.jpg)
![Page 82: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/82.jpg)
![Page 83: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/83.jpg)
![Page 84: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/84.jpg)
![Page 85: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/85.jpg)
PEMERIKSAAN PANKREAS
• 1. Foto Polos Abdomen.• 2. UGI foto/ Barium meal (pendesakan o.k. Kelainan Pancreas)• 3. Ultra Sonografi. (USG Abdomen)• 4. Endoscopic Retrograde Cholangio Pancreatography (ERCP)• 5. Computed Tomography Scanning (CT Scan)• 6. Magnetic Resonance Imaging (MRI)• 7. Angiography
![Page 86: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/86.jpg)
86
Kelainan PANCREAS • Tanda radiologis- 67 % menyebabkan pergeseran gaster- 41% invasi ke gaster- 67% menekan gaster dan duodenum- Perubahan mucosa duodenum- Inverted “3” sign - Gangguan fungsi
![Page 87: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/87.jpg)
87
GAMBARAN USG PANCREAS
• Arah probe transversal, anterior pararenal space
• Tergantung pemeriksa, akurasinya bisa 95%
• Reflektivitas hiperechoic homogen, lebih tinggi dari liver
![Page 88: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/88.jpg)
88
TEHNIK USG
• Transabdominal
• Doppler USG
• Endoscopic ultrasonography
• Intra operative ultrasonography
![Page 89: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/89.jpg)
89
Chronic Pancreatitis (horisontal section). Irregular contour (arrowheads); strongly echogenic foci (long curved arrow) and dilated section of main pancreatic duct (straight arrow)
![Page 90: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/90.jpg)
90
Small pancreatic carcinoma in the head with dilatationof the main pancreatic duct (curve arrow). There is a very uniform echo pattern within this small tumour
![Page 91: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/91.jpg)
91
USG LIVER
![Page 92: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/92.jpg)
![Page 93: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/93.jpg)
![Page 94: Kuliah 4 - GI Imaging Kls 2 RIM](https://reader034.fdocuments.net/reader034/viewer/2022050805/5695d27c1a28ab9b029a9bda/html5/thumbnails/94.jpg)
94
Alhamdulillah...