ct-scan dan usg
DESCRIPTION
radiologiTRANSCRIPT
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CT-SCAN
Dr.H.Sigit Widodo,Sp.RBagian RadiologiFakultas Kedokteran Universitas Trisakti
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Computed Tomography (CT)Scan
Basis Principle
The Interval Structure Of Any 3 Dimensional Subject Can be Reconstructed from many different Projections / Views of that subject
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Minimal diperlukan 180 Projections yang berbeda untuk memperoleh Radiograph yang bernilai Diagnostik (X-Ray Beam Were Directed Through The Tissue at 1° Interval Until 180 Readings were made)
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Fungsi Scan Unit
Collecting Large Amount of Transmission Data for Processing By the Computer
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CT-Scan Generasi -1
EMI Mark-I 80x80 Pixel Resolution (th 1972)
1 Slice 4.5 Min Scan time 1.5 Min Reconstruction time
Karena Long Acquisition Time & Cardiac & Respiration Motion
Semula CT-Scan hanya untuk Head Scan Rotate / translate, pencil Beam hanya 2
(dua) detector, Keuntungan : Scatter ↓ (Pencil Beam )
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CT-Scan ,4 bagian Utama :
1.Scan Unit
a.Patient Table / Couch
b.Gantry Central Opening Gantry Aperture
*Ada X-Ray Tube Radiation Detector Array
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2.Processing Unit :
Computer takes raw data and convert it into picture form
Computer yang membedakan CT dari Conventional Radiography
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3.Display unit / Direct Display Console Gray-Scale Television Screen Enlargement Contrast Scale Manipulatorry Substraction Operator Console
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4.Storage System Main Memory , Floppy Disc. Magnetic
Tape Radiograph / Polaroid Film
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CT-SCAN GENERASI 2
Rotate / translate / Narrow Fan Beam Detector 30 X-Ray : 30x D.P.I Scan Time / 1 Slice : 18 Sec
(15 x > cepat D.P 1 )
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CT-SCAN GENERASI 3
Rotate / translate / Wide Fan Beam Detector > 800
Joined X-Ray tube dan detector rotate together around the patient without translation Scan time 0.5 – 5 Sec
Problem : Ring artefacts
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The Scope of Diagnostic Imaging
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Scanner Principles Sejak CT generasi 1(th 1972), Data Gathering
has Progressed through 4 (four) generations. Generasi 1 perlu 4 ½ Minute per slice Generasi berikutnya mempersingkat Scan
Time CT generasi 4 : Scan Time per slice 2- 10
second Ada ≥ 600 Detector melingkari pasien dalam
Gantry 1 (Satu) X-Ray tube berotasi 360º Data
Collection
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CT-SCAN GENERASI 4 (AKHIR 70)
Rotate/ Stationary Meniadakan Problem Ring Artefact
4800 Detector Removed From Rotating Gantry Placed in Stationary 360º Ring Around the patient
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CT-SCAN GENERASI 5 Stationary Khusus untuk jantung Tidak digunakan Conventional X-Ray
Tube ART Of Tungsten Encircles The Patient,opposite to detector Ring
High Energy Electron Beam Strike Tungsten X-Ray Scan Time 50 MSec Dapat CT-Movies of Beating Heart
disebut juga Electron Beam Scanner
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CT-SCAN GENERASI 6 (Helical Spiral)
The X-Ray Tube Rotates around the patient in a helical pattern, while the patient and the table are translated through the gantry
Entire scan time can be performed within a single breth hold (30 second for entire abdomen)
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CT-SCAN GENERASI 7
Multiple Detector Array
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DETECTOR
1.Xenon (Gas) High Pressere 25 ATM Position Fixed to X-Ray Source
Tidak bisa pada generasi 4 Ionization Detector Electronic
Signal Amplified & Digitized
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2.Solid Detector Crystalline Dielectric CdWO4 /
Yurium / Gadolinium Ceramic X-Ray Scintillator Light
Photo Detector Electrical Signal Dipakai pada generasi 4
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CT-Scan Cranium
Irisan Sejajr OML (Orbito Meatal Line)
Dari Foramen Magnum s/d Vertex Ketebalan Irisan 5-10 mm Polos – Kontras Window : 1.Otak 2.Tulang
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OML = Reids
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Deskripsi = Evaluasi
I.Differensiasi antara White Matter (Substansia Alba) dengan Grey Matter (Substansia Grisea)
II.1.Brain Stem (Med.Oblongata, Pons) dan Cerebellum2.Cerebral Hemisphere (Lobus Frontalis, Temporalis, Parietalis Occipitalis)3.Basal ganglia, Thalamus
Rongga Cairan Cerebrospinal Sistem ventrikel Cisterna, Fissura, SulciIII.Tulang - tulang
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CT-Scan Abdomen
Potongan Axial = Transversal Whole Abdomen : Proc.Xyphoideus
s/d Symphisis Pubis Abdomen Atas : Proc.Xyphoideus s/d
Spina Iliaca Superior (Ginjal) Abdomen Bawah (Pelvis) : L-5 s/d
Buli-buli (Prostat)
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Puasa : 8 jam Media Kontras :1. BaSO4 1 jam . ½ jam 5- 10 menit sebelumnya @300-400
cc (Gaster-Usus Halus) 2- 3 jam
sebelumnya 400-600 cc(Colon Proximal)
Enema 200 – 300 cc (Colon Distal)2.Intra Venous
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Bone +1000
+400
Hematoma +100Grey MatterWhite MatterOedemaCSFWater 0Fat Tissue
- 100
AIR - 1000
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CT-Scan Thorax
Potongan Axial dari Apex PAru s/d Diapgragma langsung dengan kontras I.V
Tebal 5-10 mm Dicetak dalam 2 window level
paru dan mediastinum
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Evaluasi :1.Pulmo Parenchyme : Nodule / Mass Bronchus : Terbuka A.V Pulmonalis : Tapering Hilus :KGB Pleura
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2.Mediastinum :KGB Pengelompokkan/ Pembesaran
3.Cor, Aorta Thoracalis, V.Cava Superior
4.Tulang dinding thorax (Vert.Thoracalis, Costae, Sternum)
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Kelebihan CT-Scan
1. Cross-Section Imaging,Over Laping(-)2. Contrast Resulotiun baik.Dapat bedakan
Soft Tissue(Grey Matter dari White Matter,Brain)
3. Geometric Accuracy,Distortion Free dapat mengukur tepat : Jarak,diameter, tebal, displacement.Digunakan untuk rencana operasi / Radioterapi
4. Tissue characterization Menggunakan CT Number Soft Tissue Mengukur Bone Mineral Content
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Kekurangan CT-Scan
1.Geometric Miss GM Contrast Miss CM Nodule yang luput antara 2 (dua) slice :
GM
Window widh yang lebar (contrast Kurang) Window Widh yang sempit pada window
level yang salah : CM
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2.Artefact Partial volume avera ging Geometric oversight High Density oversight High Density Artefact Motion Artefact