Metode Pengukuran Volume Perdarahan Pemeriksaan MSCT Kepala pada Kasus Intraserebral Hemmorhage

Background: Intracerebral hemorrhage is bleeding in the brain parenchyma. An accurate measurement of bleeding volume to determine the appropriate medical action. This study to determine the method of measuring the volume of intracerebral hemorrhage in MSCT examination of the head and determine the advantages and disadvantages between the manual method (Broderick, ABC's, Ellipsoid) and the software method (automatic volume, otsu).Methods: This type of descriptive qualitative research with the Literature Review. Data obtained by identifying problems then searching for keywords, looking for several journals sourced from databases such as Google Scholar, Science Direct, Springer. Data analysis by studying theoretically the method of measuring the volume of bleeding methods manually (Broderick, ABC’s, ellipsoid) and using software methods (automatic volume, otsu).Results: The results of measuring the volume of bleeding in the same patient with the manual method (Broderick) produce more bleeding volume (overestimate) that is 8750 mm3 from the 7960 mm3 automatic volume method. The manual method (Broderick, ABC’s, Ellipsoid) uses the ABC / 2 formula and uses 5 mm slice thickness, the automatic volume software method uses 1 mm slice thickness segmentation and technique, while the otsu software method uses 2.5 mm segmentation and slice thickness techniques.Conclusion: The advantages of the manual method (Broderick, ABC’s, ellipsoid) take approximately 1 minute to determine the estimated outcome of the bleeding volume, the weakness is higher in irregular bleeding. The advantages of the software method (automatic volume, otsu) in the use of precise segmentation techniques for accurate volume results, weaknesses are too long in determining the estimated bleeding volume results.

Rancang Bangun Alat Bantu Pemeriksaan Knee Joint pada Kasus Osteoarthritis

Background : The Knee joint is a hinge joint with a change formed by the two condyls of the femur that are jointed with the superior surface of the tibial tube. Radiographic examination of the knee joint on AP weight bearing and lateral weight bearing projections is a good projection in revealing joint gaps in the knee joint. The constraints on this examination are when patients who have little difficulty standing on one leg when doing lateral projection of weight bearing. So that a knee joint examination tool is needed in the case of osteoarthrithis.Methods : The purpose of this study was to describe the design, study the function tests and performance tests of knee joint hearing aids in the case of osteoarthrithis.This research is a type of experimental research with the design of a one shoot case study. Data collection is obtained by a check list of results of functional tests and performance test tools. The data obtained was assessed by Guttman's scale and conclusions and suggestions were drawn.This study produced a design in the form of a knee joint examination tool. The tool is made of stainless steel pipes, on a pedestal made of wooden boards, foam and cloth. Based on the calculation of the check list using the Guttman scale.Result: The function test results were 100% and the performance test results were 96%. Until the knee joint examination tool in the case of osteoarthrithis is said to be feasible to use.Conclusion : This knee joint examination aid has a number of parts, a pedestal made of wood sheets, adjustable footrests, and a patient's padded arms. The auxiliary framework uses a 3 cm diameter stainless steel pipe with a thickness of 1 mm. Based on the functional tests in the Radiology Installation of Prof. Dr. Margono Soekarjo Purwokerto obtained results 100% for knee joint examination in osteoarthritis cases with AP weight bearing projections and lateral weight bearing. Based on performance tests which involved 5 respondents who were radiographers were said to be very appropriate with a percentage of 96% with an excess of ease in operation, reducing the movement of patients, and helping the radiographers to produce informative radiographs.

Informasi Diagnostik Pemeriksaan Appendikografi Oral dan USG dalam Menegakkan Diagnosis Appendisitis

Background: Patients with suspected appendicitis are always asked by the sending doctor (Pediatric Surgeon) to ask for an oral appendicography examination without seeking other investigations such as ultrasound or CT scan. Whereas in the oral appendicography examination, false negative often occurs so that the patient is exposed to radiation several times until the barium reaches the caecum area and no more barium is still in the small intestine. Compared to the oral appendicography examination, ultrasound examination is easier in patient preparation, cheaper in terms of cost and more safety against the dangers of X-ray radiation.Methods: This research is a descriptive analytic study conducted with a cross sectional approach. The study was conducted by providing interventions for ultrasound examination before carrying out an oral appendicography examination. Ultrasound examination of the appendix is an examination using ultrasound waves with a frequency of 5-7.5 MHz or 2-4 MHz to diagnose appendicitis. Oral appendicography examination is a radiological examination to confirm the diagnosis of appendicitis using 100 grams of barium sulfate contrast medium diluted to a volume of 200 ml that is administered orally.Results: Diagnostic information obtained on oral appendicography examination of suspected appendicitis in radiology department Roemani Hospital, among others, can show the presence of calcification and the length of the appendix organs can be measured. Diagnostic information obtained on ultrasound examination of suspected appendicitis, among others, can show the presence of debris (pus), can evaluate the thickness of the intestinal wall and its vascularity.Conclusion: Ultrasound examination for suspected appendicitis is the first choice in diagnosing appendicitis than oral appendicography because it can be done in a faster, safer, more convenient and non-invasive manner and the cost of ultrasound is cheaper than oral appendicography.

Teknik Pemeriksaan Kedokteran Nuklir Bone Scan di Instalasi Radiologi RSUP Dr. Kariadi Semarang

Background: A bone scan or commonly referred to as bone print is nuclear medicine examination using a radioactive substance or radiopharmaceutical that is inserted into the body through intravenous injection which aims to help diagnose abnormalities that occur in the bone. This imaging procedure uses a radiopharmaceutical 99mTc-MDP (methylenediphosphonate) is the most commonly used radiopharmaceutical.Methods: The patient will be injected with this radiopharmaceutical at a dose of 15-20 mCi, through the vein in the hand. Imaging can be done as soon as the radiopharmaceutical is injected or after a while to wait for the radiopharmaceutical to be distributed and absorbed by the bone, about 3-5 hours later. Imaging is done by three-phase method, namely the first phase (Vascular phase), the second phase (Blood Pool phase), and the third phase (Total body phase) l.Results: The bone scan method is an efficient examination because in 1x the imaging can provide a complete picture from the head to the foot. Evaluation of results, under normal conditions the distribution of radioactivity in the bone appears symmetrical.Conclusion: In the process of bone metastasis, it can be seen that typical pathological radioactivity can be multiple (multiple hot spots). Malignant tumors can be distinguished from benign tumors by blood pool examination.

Verifikasi Geometri Kanker Nasofaring dengan Epid pada Pesawat Linac di Unit Radioterapi Instalasi Radiologi RSUP Dr. Kariadi Semarang

Background: In Indonesia, nasopharyngeal cancer ranks 4th most in malignancies. As a method of treatment, the development of radiotherapy has made it possible to give high doses to tumors with little risk of healthy tissue, but still maintain accuracy by performing geometry verification procedures. The purpose of this study was to determine the geometry verification procedure of nasopharyngeal cancer with EPID on the Linac plane in RSUP Dr. Kariadi Semarang; the average geometric shift that occurs and why is only done before fractions 1 and 4 only.Methods: This type of research is qualitative with a case study approach. The data is taken from February 2019 to June 2019 by the method of observation, documentation and interviews. The data obtained were analyzed by interactive models, making transcripts of interviews then reduced and processed in the form of open coding, presented in the form of quotations and concluded.Results: The results showed that the geometry verification procedure was started by making a calendar treatment, adjusting the patient's setup at the origin point, switching to the iso center point. Take the image portal with EPID AP and Lateral projections. Match image portals with DRR images. Then the geometric shift data were obtained with a mean shift from the iso center in 5 patient samples: vertical axis 0.15 cm to superior; longitudinal -0.01 cm anteriorly and laterally 0.04 cm to the right. Tolerance limit of 0.3 cm. This verification is only done before fractions 1 and 4 because of the high service load.Conclusion: The geometry verification procedure has been going well with the results of the shift is still below the tolerance limit. Verification information before the 1st and 4th fractions was not enough to assess the accuracy of the irradiation carried out properly maintained.

Analisis Variasi Flip Angle terhadap Informasi Citra Anatomi pada Sekuen 3D TOF MRA Brain dengan MRI 3 Tesla

Background : Magnetic Resonance Angiography is a diagnostic imaging method that can display images of blood vessels. MRA imaging on MRI 3 Tesla provides high spatial resolution making blood vessel contrast increased so that the intracranial vessels are clearer. The efficient technique that does not use contrast media in MRA is Time of Flight. 3D TOF imaging is good for visualizing intracranial vessels. In this method the appropriate flip angle will produce a hyperintense picture of the blood vessels. This study aims to determine the effect of flip angle on anatomical image information on 3D TOF MRA Brain.Methods : This type of research is a quantitative experimental approach, conducted in February 2020 in Pertamina Central Hospital, South Jakarta. Research by conducting flip angle variations of 15°, 20°, 25°, 30° in the 3D TOF sequence of the Brain against 10 volunteers. Criteria for volunteers are healthy people aged 18-25 years. The results of the images were assessed by 3 respondent, including Internal Carotid Artery, Vertebral Artery, Basilar Artery, Anterior Cerebral Artery, Posterior Cerebral Artery, Middle Cerebral Artery, Anterior Communicating Artery, Posterior Communicating Artery. Then the Kappa test was carried out followed by the Friedman test to find the highest mean rank and comparison of flip angle in anatomical information of 3D TOF MRA Brain.Results : The results showed that there was an effect of changes in the values of the flip angle to the anatomical information on 3D TOF MRA Brain with p 0,05. The optimal Flip angle value is obtained based on the highest mean rank value which is flip angle 25° with a value of 3,22. The higher the value of flip angle, the greater the signal and contrast, but many slow flowing blood vessels will hypointens.Conclussion : There are difference in anatomical image information of 3D TOF sequence among 4 variation flip angle on examination MRA Brain. Flip angle 25° is better than 15°, 20° and 30° at anatomy information on 3D TOF sequences to show intracranial artery because it has a higher mean rank value.

Pemeriksaan Os Cruris dengan Proyeksi Modifikasi Arah Sinar Horizontal pada Kasus Fraktur

Background: Os cruris examination technique with modification projections is usually done in patients with fracture cases.Methods: This study aims to determine the results of the positioning, examination techniques, and radiograph results of the os cruris examination technique with projected modifications in fracture cases. The design of this research is descriptive research with a case study approach. In the case of research fractures using 4 samples and data collection by observation, checklist, documentation, and interviews.Results: the os cruris examination technique with projected modification in fracture cases can already diagnose well but does not produce true lateral radiographs.Conclusions: Projection modification is done if there is a fracture in the os cruris area in a non-cooperative patient so that it can provide more optimal radiographic results and the patient will be more comfortable when positioned.

Faktor Eksposi terhadap Kualitas Citra Radiografi dan Dosis Pasien Menggunakan Parameter Penilaian Signal to Noise Ratio (SNR) pada Pemeriksaan Thorax Posteroanterior dengan Menggunakan Pesawat Computed Radiografi

Background: The research was analyzing digital image quality and estimation dose patient by using Signal to Noise Ratio (SNR) on Computed Radiography. SNR can be used for analyzing digital image spatial resolution and estimation dose accurately. The aims of this study to determine the influence of exposure factors on image quality and estimation dose patient.Methods: This type of research is a quantitative method with an experimental study. Direct experiments in August 2020 assessment with a sample of 9 adults posteroanterior chest photo with the average age of 20-50 years old with an average body weight of 50-69 kilograms. Results: The measurement results showed that the digital images will be analyzed by SNR, so it can be determined the optimum exposed factor of the highest SNR value and dose radiation. From the analysis, the highest SNR value at 121 kV, current 1 mAs, the lower dose radiation at 121 kV, current 0,9 mAs.Conclusions: There was an influence variation of an exposed factor on the quality of the image and dose to the patient.

Prosedur Pemeriksaan MRI Leher pada Kasus Karsinoma Nasofaring di Instalasi Radiologi RS Ken Saras Kabupaten Semarang

Background: Magnetic Resonance Imaging (MRI) is a diagnostic imaging modality that can generate slices anatomy body multiplanar by contrast in a very good resolution. The results of the of an MRI description is more accurate for diagnosing Carcinoma of the nasopharynx. On examination of of the neck MRI with the case of carcinoma, after infusion of contrast Moeller and Reif (2003) suggested to use T1 TSE Coronal and axial sequence and using the 4 mm slice thickness , but in Radiology instalation of Ken Saras Hospital using T1 and T1 TSE TSE Fat Saturation Coronal, sagittal and axial sequence as well as using slice thickness 2 mm in axial slices. The purpose of this research is to know the procedure of examination of of the neck MRI in the case of Carcinoma of the nasopharynx, justifying T1 Fat Saturation sequence after infusion media kontaras and reasons of wearing slice thickness 2 mm in axial slices.Methods: This type of research is qualitative research with case studies approach. Data retrieval is done by observation, documentation, interviews with two specialists in radiology, 2 radiografer and 1 doctor who send the patient. The data obtained analized by using the table categorisation and coding.Result: The results of the research showed that MRI examination procedure of the neck in the case of Carcinoma of nasopharynx in Radiology Installation of Ken Saras hospital using T1 TSE multi planar (coronal, sagittal and axial), T2 TSE multi planar and T2 TSE Fat Saturation multi planar sequences before infusion of contrast media, T1 and T1 TSE TSE Fat Saturation multi planar sequences after infusion contrast and using the slice thickness 2 mm in axial slices. Addition sequence T1 TSE Fat Saturation after infusion of contrast aimed to clarify the limits of the tumor with surrounding tissue and image of Lymphadenopathy.Conclusion: While using 2 mm slice thickness in axial slices aims to show the abnormalities or nodules-small nodules on the nasopharynx and to see the expansion Stadium in the surrounding area of the nasopharynx.

Standarisasi Indeks Eksposur untuk Memenuhi Kriteria Anatomi dan Aspek Teknis pada Radiografi Thorax Pediatrik

Background: Computed Radiography has an exposure index that used as an exposure indicator. But on radiographic examination, exposure index value sometimes ignored, and in the preliminary survey of pediatric chest examination resulting a large exposure index range. The aim of this study is to know the profile of exposure index value and the setting of the exposure factors, the assessment of anatomy criteria and technical aspect, and the right exposure factors such as kV and mAs on pediatric chest examination.Methods: The type of this research is descriptive quantitative. The research was done by collecting data related to pediatric chest radiograph (≤ 2 years) the value of exposure index was recorded, then the radiograph was assessed using questionnaires that filled by one respondent who is a radiologist. The data was analyzed by displaying the data of exposure index and anatomy criteria from questionnaires into the table form, and then conducted a descriptive analysis to be drawn conclusions.Results: The results showed the profile of exposure index value and the setting of the exposure factor has a fairly large exposure index range of 1084 – 2175, using 40 kV and 10 mAs and the collimation still often exceeds the object. Then for the assessment of the thorax anatomical criteria and the technical aspect overall was “Good Enough”, and the right exposure factors, that is: at 6 and 7 cm chest thickness was using 60 kV and 1,6 mAs; at 11 cm chest thickness was using 60 kV and 2 mAs, FFD 100 cm, and the setting of collimation as wide as object, the exposure index generated in the normal range that is 1251 – 1382.Conclusion: The right exposure factors on pediatric chest examination, that is: at 6 and 7 cm chest thickness was using 60 kV and 1,6 mAs; at 11 cm chest thickness was using 60 kV and 2 mAs, FFD 100 cm, and the setting of collimation as wide as object.