Membaca Imaging Radiologi.pptx
Transcript of Membaca Imaging Radiologi.pptx
Membaca Radiologi Fraktur WajahSandy S.S.
Pemeriksaan fisik = deteksi paling sensitif
Rodriguez ED, Dorafshar AH, Manson PN. Facial fractures. In: Neligan PC, editor. Plastic surgery. 3rd ed. New York: Elsevier-Saunders, 2013. p. 51.
Anatomi
Anatomi
Anatomi
Foto Roentgen
AP, lateral, Waters, panoramik C-spine clear?
Hollier Jr L. Kelley P. Soft tissue and skeletal injuries of the face. In: Thorne CH, Beasley RW, Aston SJ, Bartlett SP, Gurtner GC, Spear SL, editor. Grabb & Smith’s plastic surgery, 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2007. p. 317.
Foto Roentgen
Identitas Intensitas Scope Simetri
Fraktur vs sutura vs lekuk pembuluh darah
Dislokasi Opasitas abnormal
AP
Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2nd ed. Philadelphia: Elsevier-Saunders, 2005. p. 13-42.
Lateral
Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2nd ed. Philadelphia: Elsevier-Saunders, 2005. p. 13-42.
Proyeksi Towne
Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2nd ed. Philadelphia: Elsevier-Saunders, 2005. p. 13-42.
Waters
Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2nd ed. Philadelphia: Elsevier-Saunders, 2005. p. 13-42.
Panoramik
1. Zygomatic arch2. Maxillary sinus3. Pterygoid plate4. Nasal septum5. Articular eminence6. Glenoid fossa7. Mandibular condyle
8. Sigmoid notch9. Coronoid process10. Mandibular ramus11. Mandibular angle12. Mandibular body13. Mandibular canal14. Mental foramen
15. Mandibular symphysis16. Antegonial notch17. Hyoid bone18. Edentulous maxilla19. Edentulous mandible
Fraktur nasal
Foto waters(1) Fr nasal dg lateral displacement(2) Medial displacement dari proc.frontalis maxilla sin(3) Lateral displacement dari proc.frontalis maxilla dext(4) Septum deviasi
Fraktur zygoma
Foto Waters:(1)Fr zygomaticofrontal(2)Fr infraorbital(3)Fr proc.zygomaticus
dari os temporal(4)Gambaran radioopak
pd sinus maksilaris
Foto Waters: (1)Fr rima orbita inferior(2)Fr basis orbita(3)Air-fluid level pd sinus maksilaris.
Fraktur maksila
LeFort I: garis fraktur transversal sedikit di atas akar gigi dan melingkar sehingga memisahkan maxilla menjadi 2 fragmen
Fraktur maksila LeFort II (pyramidal
fracture): mirip Le Fort I pd bagian lateral kiri dan kanan makin ke medial seperti piramid melewati bagian medial orbita dan bertemu dg sisi sebelahnya
Maxillary Fracture LeFort III (craniofacial
dysjunction): melepaskan hub antara zygomaticofrontal junction, nasofrontal junction dan berlanjut kedasar orbita kesisi yang lain
(1)Fr horizontal dari midface (2)Fr dinding medial dari sinus
maksilaris (1)Garis fraktur yg menembus ddg anterior dari sinus maksilaris, (2) ddg posterior sinus maksilaris, dan (3) maloklusi
(1)Fr zygomaticofrontal bilateral(2)Fr pros.frontalis(3)Fr septum nasal(4)Fr infraorbital bilateral(5)Fr basis infraorbita dext
Garis fraktur yang melewati (1) sinus frontalis, (2) ethmoid, (3) sinus maksilaris dan (4) pterygoid
Fraktur mandibula
1. Condylar head or intracapsular fracture
2. Subcondylar fracture
3. Coronoid fracture4. Ramus fracture5. Angle fracture6. Body fracture7. Symphysis
fracture
(1)Fr ramus mandibularis komplit
(2)Fr angulus mandibularis komplit
Fraktur mandibularis komplit
Fraktur proc.coronoideus komplit Dislokasi TMJ
Foto Towne’s yang memperlihatkan fraktur ramus mandibularis bilateral
Fraktur proc.condylaris
(1) fraktur parasymphisis mandibula dan (2) fraktur ramus mandibula
Kasus
http://www.stritch.luc.edu/lumen/MedEd/Radio/curriculum/Neurology/Head_trauma2.htm
http://images.radiopaedia.org/images/25042/e3f99d2b616c9e4c6b8920b6f2ff10.jpg
Fraktur linear dan fraktur depresi
Dislokasi TMJ
Kasus
http://www.abstractsonline.com/EPosterViewer/MediaPreView.aspx?Ckey=%7B88399FA8-DBD5-4C24-A400-AB053E4E6946%7D&Mkey=%7B22FDF1E0-BB98-47D9-B084-94213A1B7D4D%7D
Fraktur blow out orbita dg fraktur dasar orbita
CT scan
Fraktur Jaringan lunak Hematoma Air fluid level Dinding orbita, otot ekstraokuler
3D: orientasi keseluruhan
Rodriguez ED, Dorafshar AH, Manson PN. Facial fractures. In: Neligan PC, editor. Plastic surgery. 3rd ed. New York: Elsevier-Saunders, 2013. p. 51.Hollier Jr L. Kelley P. Soft tissue and skeletal injuries of the face. In: Thorne CH, Beasley RW, Aston SJ, Bartlett SP, Gurtner GC, Spear SL, editor. Grabb & Smith’s plastic surgery, 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2007. p. 317.
CT Scan
Densitas fokal ↑(perdarahan, ca, logam)/↓ (edema, stroke)
Simetri pola gyrus Midline shift Ukuran dan posisi ventrikel Sinus: cairan, massa Pembengkakan jaringan lunak Fraktur
http://w-radiology.com/skull-ct-anatomy.php
http://www.drstretch.net/graphics/reconstructive/ws_zygoma_Z_F_b.gifhttp://img.medscape.com/pi/emed/ckb/otolaryngology/834279-1048674-867687-1674168.jpg
Hematoma sinus maksilaris dxDiskontinuitas os maksilaris dx, sphenoid dx
CT scan 3D
3D reconstructionFraktur panfasial
Terima kasih