Coass Radiologi K.B.K
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Radiografi KonvensionalThorax
Dr.Surjadi Sujana,Sp.Rad
Departemen Radiologi
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Kondisi Foto Thorax
1. kondisi paru
2. kondisi tulang
3. foto layak dibaca / tidak :
( foto tak sesuai dgn ygdiminta/ goyang)
( foto tak memenuhi
syarat : apex / sinusterpotong,dll)
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Cara mengukur besar jantung pd foto thorax
PA
Yang lazim dipakai :
Cardio -Thorasic Ratio ( C.T.R )
Yaitu membandingkan besar jantung sebenarnya
dengan lebar dinding thorax
Syarat mengukur C.T.R :• foto thorax posisi PA.
• simetris.
• pasien harus deep inspiration
• jarak focus X ray ke film harus 1,8 – 2 m• NB:deep inspiras diafragma dextracosta 9-10
kanan bawah.
CTR dewasa normal < 50%, anak2 Normal < 55 %
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Jantung
• Batas jantung pada posisi foto PA :
dextra : - atrium dextra - hilus dextra
- aorta ascenden - arcus aortae.
(elongatio/kalsifikasi > 30 th)sinistra : - aorta descenden - hilus sinistra.
- segmen pulmonal - ventrikel sinistra.
NB: foto thorax PA normal yg tak membentukbatas jantung: ventrikel dextra dan atrium
sinistra
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Jantung
• Untuk menilai arcus aorta, biasa usia > 30 tahun.
• Untuk menilai apex cordis, harus diketahui CTR nyabesar atau tidak
• Bila CTR > 50% (dewasa); > 55% (anak)
maka apex cordis harus dilihat ada/tidaknya
deviasi ke laterokranial atau laterokaudal
NB : laterocranial (RVH), laterocaudal (LVH)
NB ; arcus aortae, (N): > 1 cm dibawah angulus ludovici.
Atau lengkung aorta > 4 Cm pd usia tua.Perlu diperhatikan ada /tidaknya kalsifikasi arcus aortae.
ini ada hubungan dengan penyakit coroner.
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Pembesaran jantung foto PA
• Right Atrium :
ke lateral dextra.( > 1/3 batas dextra)
• Right ventrikel :ke anteriormenempel > l/3 sternum
lateral apex deviasi kelaterokranial.
latero-superior
pinggang jantungdatar.
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Pembesaran jantung foto PA
• Left Atrium :
ke superiormendesak mean bronchus kiri ke cranial
ke antero-medialmembentuk double contour pd bagian
kanan jantung
ke lateral membentuk batas jantung kiri
ke Posterior mendesak oesphagus di posterior
• Left Ventrikel :
ke lateral apex cordis deviasi ke latero-caudal
ke posterior apex cordis overlap dgn vertbrae thorax.
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Pulmones
• Hila : dewasa : ukuran 9 – 16 mm; anak : seukuran
trachea
• Trachea : normal letak lurus ditengah.
• Pulmones : - infiltrat - kesuraman - konsolidasi- hiperlusen/ kavitas/ bulla/ bleb/ kistik
- noduler / kalsifikasi.
• Corakan bronchovaskuler :meningkat/ kasar
• Pleura : ada efusi / pneumothorax/hydrothorax• Diafragma/sinus : setinggi costa ke-9-10 kanan belakang
• Tulang / Soft : fracture / emphysema subcutis ?
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Deskripsi pulmones
6. Bleb : ukuran < 4 cm ; dinding tebal; tidak ada air fluid
level
7. Kavitas : dinding tebal; ukuran relatif ; ada air- fluid level;
lokasi diapex pulmones8. Absces : dinding tebal disertai air fluid level; biasa ok
suatu proses infeksi nonspesifik.
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Mediastinum
Rongga thorax (mediastinum) dibagi 2
ruangan :
1. Mediastinum superior :
batas insisura yugularis ke superior.2. Mediastinum inferior : dibagi 3 bagian
anterior: sternum pericard anterior.
medius : ditempat jantung & adnexanya
posterior: jantung vertebrae thorax.
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Bronchovaskuler
Normal : bronchiolus terminalis s/d alveoli
tak dpt dilihat pada foto,yg tampak opak bergaris
ialah pembuluh darahnya.
karena bronchiolus berjalan beiringan dgn
pembuluh darah maka disebut :bronchovaskuler
• Bronchovaskuler : meningkat / tidak
kasar / tidak.
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Pleura :
Secara anatomi pleura terdiri dari :
• Pleura parietalis : menempel pd dinding thorax
sulit dinilai dgn foto thorax.
• Pleura fiseralis: menempel pd parenchym paru,
bisa tampak bila ada kelainan seperti pada :
pneumothorax; pleural efusion; penebalan padatumor pleura : mesothelioma.
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Diafragma/Sinus :
• Diafragma: membatasi rongga thorax dan abdomen
• Normal : deep inspirasi, letak diafragma dextra setinggiiga ke X kanan belakang (orang gemuk IX)
• Sinus : lazimnya costo-phrenicus lancip
cardio-phrenicus tak dinilai.
• Kelainan2 Diafragma: Hernia; paralisis; eventrasio;
scalopping; tenting; drumdery
• Kelainan-2 Sinus : hanya sudutnya tumpul /lancip.
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Tulang-2 / Soft tissue :
• Tulang-2 (thoraxic cage) meliputi :costae,clavicula dan vertebrae thoracalis.
• Normal: letak costae belakang A
letak costae depan Vletak mendatar biasanya abnormal
• Intercostal space :normal: 2,5 cm(dewasa)
• Kelainan: fracture; bridging; costabifida; cervicalribs
• Soft Tissue : ada emphysema /oedema/tidak ?
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Kesimpulan/ Conclusion :
• Kesan : hasil expertise dari foto thorax mulai
cor : tampak/tidak cardiomegali
pulmones : ……..?
tulang : ……..?
• DD/ bila ada …..?
• Pemeriksaan anjuran : yg berhubungan dengan radiologi
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Kelainan parenchym paru
• 1. infiltrat : bila multiple dan millier KP.
• 2. infiltrat millier pada orang tua harus di
• DD/ - metastase.
• 3.infiltrat diapex dewasa : P.spesifik/pneumonia non spesifik.
• 4.anak2 harus dilihat hilanya melebar/tidak
• hila melebar- proses spesifik,• hila tak melebar bronchopneumonia.
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Kesuraman(opacity)
• Biasanya karena pemadatan alveoli, ok ;peradangan/darah/kolaps/desakan/efusi/tumor.
• Bila salah satu lobus tampak opak :
• Perhatikan :trachea ,mediastinum.costae.
• Bila tak ada deviasi mediastinum:------ pneumonia.
Bila deviasi mediastinum ke kontra lateral:
---- efusi / mass di pulmo.
Bila deviasi mediastinum ke ipsilateral :
-- kolaps paru / agenesis pulmones.NB : opacity didistal pleural line -
hematothorax/efusi/pyothorax/ chilothorax.
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Gambaran hyperlucent paru
• 1. gambaran hyperluscent diparu perlu
diperhatikan apakah masih tampak corakan
vaskuler / tidak.
• Diperhatikan letak diafragma & sela iganya.• Bila hyperluscent masih tampak vaskuler
• /letak diafragma rendah, sela iga lebar-
kemunginkan emphysema pulmonum.
• Bila hyperluscent tanpa vaskuler apalagi tampak
• Pleural line diproximalnya,- pneumothorax.
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Garis2 linier opak diparu
• Garis linier diparu biasanya harus dibedakandengan gambaran vaskuler paru.
• 1. jaringan fibrotik :garis lurus (tak ber.cab)
• 2. fisura : biasa interlobar pleura.
• 3. garis2 Kerley : A, B , dan C.• NB : bila vaskuler biasa ukuran mengecil
• dan ada cabang2 didistalnya.
• NB: fisura horizontalis melebar encapsulatedpleural efusi.
• NB: garis Kerley ada interseptal oedema.
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Gambaran bronchitis
• Definisi : bronchitis,
• Batuk supuratif selama 3 bulan berturut2
selama 2 tahun berturut.
• Secara Radiologis : disebut dirty chest.
• 50 % gambaran normal, 50% bronchitis.
• ( tak ada gambaran khas hanya ditemukanadanya gambaran penebalan
peribronchial struktur / tream lines app.)
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Gambaran pneumonia
• Bronchopneumonia : secara Radiologi
ditemukan adanya :
• Opacity dibasal pulmones, dan bisa juga
terjadi dibanyak lobulus /intersegmental.
• Secara klinis :biasa disertai fibris.
• Pneumonia Lobaris/lobularis : Radiologi;
• Opacity di segmen / lobus pulmones.
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Gambaran tumor paru
• Tumor intra pulmonal / extrapulmonal;
• Intra pulmonal : noduler batas tegas/tidak.
• sudut ditepi paru lancip.
• Bila batas tegas jinak.
• Bila kurang tegas cenderung ganas.
• Extrapulmonal : nodul batas tegas.
• sudut tumpul ditepi paru.• DD/ mesothelioma/encapsulated pleural-efusi.
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Nodul diparenchym paru
• Nodul ukuran dari beberapa mm s/d Cm
• Bila jinak kemungkinan :
tuberculoma, fungus , blood clot, corpus
alienum. Thymus / thyroid /teratoma.
Bila ganas kemungkinan :
bronchogenic , metastase , pancost tumor.
NB/ pancost ada destruksi costa di apex.
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Kelainan2 Diafragma
• 1. kelainan karena : gangguan penutupan• seperti : hiatus diafragmatica.
• hernia diafragma : Morgagni
• lubang hernia di depan / kanan.
• hernia diafragma : Bodalek;
• lubang hernia di belakang kiri.
• 2. kelainan karena persarafan diafragma:
• paralise diafragma ( beda letak > 1 sela iga)• 3. kelainan kelemahan otot diafragma :
• seperti : eventratio diafragma. ( diperifer)
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Gambaran metastase diparu
• 1. gambaran infiltrat miller dikedua paru.
• 2. gambaran infiltrat kasar( cotton ball ).
• 3. gambaran coin lesion
• 4. gambaran lymphangitis carcinomatosa.
• 5. gambaran bronchopneunomia.
• 6. gambaran pleural efusi masif berulang.(gambaran efusi yg serosanguinus )
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Gambaran proses spesifik
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Gambaran proses spesifik
dipulmones
• Proses spesifik dinyatakan aktif /tak aktif.• Gambaran Radiologi :
• Aktif : masih tampak infiltrat /efusi/cavitas.
• Inaktif : dewasa ; tampak jaringan fibrotik.• anak2 : tampak kalsifikasi.
• Bila tampak fibro-infiltrat : biasanya proses lamabelum jelas inaktif, harus konfirmasi dengan foto
thorax terdahulu.• Dinyatakan tenang bila gambaran radiologinya
menetap selama 3 bulan berturut2 tanpa terapi.
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Gastro-intestinal tractus
• GI.Tract : mulai cavum oris s/d anus.• Proses pencernaan secara kimia/mekanik.
• Dicavum oris : kelenjar ludah : sublingual ,
• submandibula / parotis.• Di Gaster : ada asam lambung & mukosa
• Di usus halus dan besar ada resorpsi nutrisi.dancairan.
• NB : setiap perubahan epithel banyak terjadi• proses keganasan.
Pemeriksaan G I T :
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Pemeriksaan G.I.T :
• 1. pemeriksaan foto polos.• 2. pemeriksaan dgn kontras media.
• 3. pemeriksaan dgn double kontras.
• 4. pemeriksaan dgn ultrasound.• 5. pemeriksaan dgn nuclear medicine
• 6. pemeriksaan dgn CT scan / M.R.I.
NB : kontras positif : barium sulfat.
kontras negatif : udara.
nuclear medicine : dengan radio-farmaka.
Pemeriksaan G I T Radiologi
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Pemeriksaan G.I.T. Radiologi
konventional
• pemeriksaan kelenjar ludah : Sialografi .
• Pemeriksaan oesphagus : Esophagogram.
• Pemeriksaan O.M.D : esophagus gaster
doudenum ( biasa double kontras)• Pemeriksaan follow throw ; utk usus halus.
• Pemeriksaan usus besar : colon in loop (Barium
enema).• Pemeriksaan appendix : appendecogram.
• Pemeriksaan foto polos abdomen (non kontras)
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oesophagogram
• Pemeriksaan foto polos ; untuk melihatadanya corpus alienum opak.
• Pemeriksaan foto dgn kontras untuk
melihat corpus alienum non opak/ kelainan
• Dari oesophagus -atresia/penyempitan
• divertikel / varices/tumor.
• achalasia.
• NB:kontras Ba.sulfat kental .( 1 :1)
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F ll th
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Follow throw
• Dengan kontras positif :• Konsentras kontra encer (500-1000cc).
• Dibuat foto tiap 30 menit sambil dilihat
kontras mengisi sampai mana.pemeriksaan selesai setelah kontrasmengisi sampai ileum terminalis.
Yang dinilai : mukosa usus , ada/tidak ulcus.NB; sekarang jarang dikerjakan lagi,
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F t l
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Foto colon
• Colon in loop (Barium Enema)
• Kontras encer(1 :7);sebanyak 500-1000cc
• Dimasukkan lewat colon set mengisi rectum,
ampula recti,sigmoid,colon descendens,transversum, sampak ascendens.
• Dinilai : passage kontrasnya.
• mukosa, filling defect /additional.
• penyempitan/pelebaran./tumor.
• kelainan congenital..
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BNO 3 posisi
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BNO 3 posisi
• Ileus : terdiri dari ileus obstruksi/paralysis• Ileus obstruksi : terdiri dari :
• Ileus letak tinggi : distensi usus halus.
Sampai ileum terminalis,• Ileus letak rendah : bila distensi usus
dicaecum s/d sigmoid.
• Ileus paralysis : seleruh usus distensi dgn• multiple air fluid level yg panjang -2 , pd
usus halus.
Pada kasus distensi usus
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• Harus diperhatikan usus apa :
• Yeyunum : plika semi circularis.
• Ileus : ada valvula coniventes.
• Colon ; ada haustrae.
• Bila distensi tanda multipel air fluid level
diduga karena meteorismus.
• Bila distensi dgn multiple air fluid level( 6
atau lebih fluid level) - ileus.
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Tanda penumoperitoneum
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Tanda penumoperitoneum
1. Cupolla : udara yang terdapat diantaradiafragma dengan hepar / organ dibawahnya.
Bentuk cupolla sign seperti bulan sabit.
DD/ chilaiditis. ( colon yg terjepit antara
diaframga dgn hepar)2. Riglers Sign : dinding luar usus yg tampak, atau
jarak antara 2 lumen usus yg distensi lebih dari4 mm.
3. Trapped air :udara yg terjepit diantara dindingusus biasa bentuk segitiga/grs lengkung.
4. Udara di ductus billiaris.
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Invaginasi/intususepsi
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Invaginasi/intususepsi
tampak bagian intususipien / intususeptor.
Bila pada pemeriksaan dgn double kontras
tampak adanya coil spring appearences.
bila pemeriksaan non kontras kadang
ditemukan gambaran blind loop/ indentasi.
untuk strangulasi, gambaran usus tampak
seperti blind loop tapi ujungnya runcing.
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Untuk menilai ductus biliaris
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Untuk menilai ductus biliaris
• Dengan bahan kontras biligrafin.• Sekarang sudah tidak dibuat lagi karena
sudah di ganti dengan pemeriksaan lain
seperti : USG , MRI , CT scan. E.R.C.P.• Karena batu empedu bersifat radioluscent.
Sehingga perlu kontras media untukmelihatnya.
• Kadang2 batu empedu tampak opakkarena kalsifikasi bukan garam empedu.
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Obstruksi billier.
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1. Obstruksi sering karena batu empedu.
2. Peradangan saluran empedu.3. Karena desakkan tumor intra/extra
vesica fellea.
Pemeriksaan secara Radiologi konvensional1. cholecystogragi.(cholangiografi )
2. E.R.C.P.
Sekarang pemeriksaan dgn :USG /CT scan / MRI / Nuclear medicine.
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Untuk menilai appendix
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Untuk menilai appendix
dengan pemeriksaan Appendecogram.
Pasien diminumkan kontras Barium 200 cc
Dengan kontras kira2 150gram. Setelah 8-
10 jam difoto BNO & oblik posisi.
1. Appendecogram (+) appendicitis (-)
2. Appendecogram (-) appendicitis (+)/(-)
3. Appendecogram mengisi parsial (+)
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tulang
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tulang
• Yang dibicarkan tentang kelainan :
• 1. degenerasi.
• 2. fracture.
• 3. peradangan .
• 4. tumor , jinak/ ganas.
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Fracture
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Fracture
• 1. harus diketahui bentuk fracture.
• 2. tulang apa / setinggi berapa /kanan/kiri.
• 3. apakah fracture baru / lama.
• 4. adakah gambaran reaksi periost/callus
• 5. adakah dislokasi sendi didekat tempat
fracture di jauh dari lokasi fracture.
(contoh : Galliazi / Montegia )
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Peradangan tulang
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g g
1.Peradangan karena proses infeksi kumannon spesifik :
seperti ; staphylococcus,/streptococcus/
jamur , dll.
2. Peradangan karena proses spesifik :
seperti : tuberculosa.
lepra.
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Tumor tulang
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Tumor ganas tulang yang dibicarakan :
1. Osteogenic sarcoma (osteo-sarcoma)
2. Chondro-sarcoma.
3. Ewings sacroma.
4. Multiple myeloma.
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Foto B N O
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Blass Nier Oversick.:yang dinilai :
1. distribusi udara usus dalam abdomen
2. Psoas line dan properitoneal fat line.
3. kontour kedua ginjal.4. batu opak di tractus urinarius.
5. vesica urinaria.
6. tulang2,
NB:foto BNO yg lazim diafragma/symphisis/properitoneal fat line harus tampak .
Macam2 batu ditract urinarius
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1. Batu opak : tampak tanpa kontras.2. Batu luscent ; harus dgn kontras media.
Batu-batu diginjal ; dpt berupa:
* batu calsium /phosphat - opak.
* batu xanthin/oxalat - luscent.Bentuk batu di ginjal dpt : berupa kalsifikasi/
staghorn / mottle. Di P.C.S.
bila bentuk Mottle di PCS dgn calsifikasi dicortex ginjal -- batu karena proses TBC.
Bila staghorn tanpa kalsifikasi cortex metabolism.
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Pemeriksaan I V U
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Pemeriksaan IVU ; dengan kontras Iodine.lazim dipakai : kontras non ionic hypo-osmoler.
1.persiapan pasien ; dgn diet rendah serat
dan diet caian (dehydrasi ringan)
2. periksa ureum /creatinine.
3. indikasi/kontra-indikasi dgn kontras yg
dipakai.
4. riwayat penyakit pasien perlu ditanyakan.5. tensi pasien yg akan diperiksa.
Kontra-indikasi pakai kontras
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1. Allergi kontras media ( Iodine )2. Penderita sedang konsumsi obat Iodium
3. Pasien dengan riwayat asthma berat dan
penyakit cardiovaskuler.
4. Pasien sedang konsumsi obat Metformin.
5. Pasien dgn riwayat Multiple myeloma.
6. Pasein dengan chronic renal failure.
Pemeriksan IVU
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1.Setelah BNO : udara usus / fecal material sudah bersih,maka disuntikan kontras I.V.
2. Dibuat foto 5 menit setelah suntikan untuk
menilai : nephrogram / fungsi excresinya.
3.kemudian pasien diprone sampai 15 menit
untuk menilai urether dan vesica urinaria.
4. 30 menit kemudian dibuat foto BNO lagi
posisi supine , bila VU sudah penuh,dinding reguler.
5. Pasein disuruh mixtie ,dibuat foto BNO posisi
erect (tegak) menilai pengosongan VU/Ren mobilis
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Catatan :
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Bila salah satu/kedua PCS; tak tampak harusditunggu sampai 120 menit.
Bila setelah 120 menit juga tak tampak dinyataginjal bersangkutan Non visualiz.
Kemungkina:
1. Ginjal Agenesis./ post nephrectomi.
2. Spasme a. renalis bersangkuta.
3. Fungsi ginjal buruk.
4. Ada hydronephrosis besar/ polikistik kidney.5. Ren ectopik.
Catatan :
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bila pasien ada hypertensi ; pengambilanfoto pasca penyuntukan kontras harus
lebih cepat : 1 ,3 dan 5 menit, kemudian
baru 15 menit dst.Demikian juga pada anak2 pasca injeksi
kontras :foto 1 menit, 3, 5, 7 dan 20 menit
bila VU sudah penuh pemeriksaanselesai.
Yang dinilai pd pemeriksaan IVU
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1. Kontour ginjal : besar/letak/bentuk.2. P.C.S : ada
spastik/dilatasi/batas/konsentrasi kontras
homogen/inhomogen.3. Ureter :
dinding/penyempitan/dilatasi/kinking/batu
4. V.U.:dinding/filling defect/additional
shadow/indentasi/divertikel/ batu.?
Tanda U.T.I. pada pemeriksaan
IVU
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1. spastik / dilatasi pelvio-calyses siste,( calys mayor menyempit)
2. Adanya iregularitas ureter.
3. Adanya koiking ureter.4, adanya iregularitas dinding vesica urinaria.
NB: ini semua karena infeksi/batu./rentensio
urinae yang chronis.
NB: dilatasi PCS = hydronephrosis.
Tomor ginjal
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1. Nephroblastoma ; pada anak2.2. Tumor supra Renal : memberi gambaran
dropping lily pd foto IVU.
( PCS tampak menunduk )
3. Tumor dipelvis renis.
4. Tumor divesica urinaria.
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B.P.H
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Benign Prostat Hypertrophy:Dpt di nilai pada pemeriksan IVU dengan
adanya indentasi vesica urinaria dan
postero-inferior.BPH juga bisa dinilai :Cystogram/USG/CT
MRI.
Pd. B.P.H ; harus dilihat dindingnya ada/tak
kalsifikasi.
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Cystogram
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Pemeriksaan ini dengan kontras media ;Untuk menilai vesica urinaria.
1. peradangan.
2. Tumor.
3. Desakkan intra/extra vesica,
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Urethro-cystogam
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Pemeriksaan dengan kontras media dimasukanlewat urethra mengisi sampai
vesica urinaria.
Untuk menilai :
1. Ada striktur urethra.2. Adanya striktur karena desakkan prostat
3. Adanya batu di urethra.
NB : pada MCU ;os disuruh mixtie,saat midstreamurethra dijepit lalu dibuat foto urethranya.
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Tractus genitalis.
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Secara Radiologi konventional dengan;Pemeriksaan H.S.G (Hystero-Salphyngo-
Grafi);
Indikasi :1. Infertility primer/secundair.
2. Kontrol recanalisasi tubae.
3. Menilai besar uterus dan kelainan tubae.4. Menilai adanya tumor intra uterine.
Kontra indikasi pemeriksaan HSG
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1. allergi kontras media.2. adanya kehamilan.
3. adanya kelainan dicervix (peradangan).
4. adanya perdarahan banyak pervaginam.
5. adanya pelvic inflammatory disease.
6. adanya penyakit sistemik yg berat.
Pemeriksaan HSG
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Instrumentasi yang dipergunakan :1. speculum.
2 cunam cervix.
3. insertor ( dgn katheter 8 – 10 F)
4. uterus sonde.
5 spuit. 10 cc,
6. kontras media.
Penilai pemeriksaan HSG
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l. cervix uteri ( inspeculo)2. uterus. Setelah pemberian kontras.;
mukosa / filling defect /additional shadow
3. kedua tubae : melebar / peritubal filling.
4. kedua ujung tubae : ada spillage/tidak ?NB : cervix inspeculo ada erosio portionis?
NB: tuba melebar : hydrosalphynx.
NB : peritubal filling : tuba bocor,kontras keluar
dari dinding tuba/ bukan dari ujung tubae.
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Kelainan uterus :
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1, mukosa ireguler : infeksi / mestruasi.2. mukosa ada filling defect :
* myoma uteri, adenomyosis.
* blood clot.
* synechia.
* corpus alienum.
3.Kelainan bentuk uterus: didelphys / infantil
uterus septus/ dll.
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Kelainan tubae
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1. Patensi tuba : bila kedua ujung tubaeada spillage.
2. Tuba non patent: bila tak tampak spillage
3. Non patent dpt karena :* penyempitan ( hydro-salphynx GO)
* ada peritubal filling ( karena TBC)
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Expertise pemeriksaan HSG
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1. Tampak kontras masuk melaluiinserto/katheter mengisi cervix, cavum
uteri, serta kedua tubae.
2. Mukosa uterus licin/ireguler, ada fillingdefect atau additional shadow.
3. Kedua tuba :melebar/ada peritubal filling
4. Kedua ujung tubae ;ada spillage/tidak?Kesan:uterus baik,kedua tubae patent/tidak?
Angiografi.
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1. Ialah pemeriksaan pembuluh aorta/arteri/cabang2 kecil lainnya. Dengan
penyuntikkan kontras intra arterial.
2. Disini diperlihatkan suntikan intra-aortal3. Suntikan intra carotis untuk menilai nya.
kelainan arteri ; bisa
* penyempitan/pelebaran/ neovaskularisasi
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myelografi
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Suatu cara untuk pemeriksaan ruangsubarachnoid, dengan penyuntikan kontras ke
ruang sub-arachnoid,
Kelainan2 yang ditemukan:
1. Desakkan extra dural : HNP/tumor /dll.
2. Desakkan intradural/extrameduler :
seperti tumor intradural /extramedular.
3. Desakan intrameduler :tumor sel medula
spinalis / ependymoma, dll.
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