Download - Kuliah Uro Ro
-
7/24/2019 Kuliah Uro Ro
1/47
URO - RADIOLOGI
Iskandar Zakaria
-
7/24/2019 Kuliah Uro Ro
2/47
Uro-radiologi
Pemeriksaan tractus Urinarius dengan
berbagai modalitas pemeriksaan Radiologi
-
7/24/2019 Kuliah Uro Ro
3/47
Modalitas
Foto Polos Abdomen (FPA) Intravenus Pyelography (IVP) Antegrade Pyelography (AP) Retrogra!e Pyelography (RP) Urethrography "ystogarphy Ultrasonography (U#) "omputed $omogra!i #canning ("$ #an)
%agnetic Resonance Imaging (%RI) &edokteran 'uklir (Renogram) Angiography
-
7/24/2019 Kuliah Uro Ro
4/47
Angiography
Imaging o! vesel
$eknik #eldinger
-
7/24/2019 Kuliah Uro Ro
5/47
Persiapan penderita
Renal Angiografi %R#
$uuan* +unt pengamatan sblm,stlh pemeriks
+persetuuan tindakan -ebas anti koagulan (. mgg sblm)
"ukur tempat pungsi
Premedikasi
-
7/24/2019 Kuliah Uro Ro
6/47
Teknik Kateterisasi
/okasi Pungsi* + a Femoralis
+ a A0illaris
+ a -rachialis+ Aorta
$eknik* #eldinger (ahli r1 #2edia)
-
7/24/2019 Kuliah Uro Ro
7/47
Pungsi a !e"oralis
Paling sering dilakukan (aFem kanan)
%udah dicapai
&ontra Indikasi*. Arteriostenosis dari Ao3 aIliaca3 aFem
4 gn pembekuan darah
5 Aneurisma aFem
-
7/24/2019 Kuliah Uro Ro
8/47
Pera#atan le$ih l%t &setelah prosedur'
-ed rest .4 am3 p0 dipulangkan stl 46 am7bservasi tempat pungsi
'3 $8 tiap 9 am3 kmd tiap 6 am dlm 46 am
$emp3 RR tiap 6 am dalam 46 am
-
7/24/2019 Kuliah Uro Ro
9/47
Ko"plikasi
&omplikasi akibat kontras media*+ Alergi (ringan s,d berat)
&omplikasi akibat teknik*+ :ematom
+ $erbentuk thrombus
+ In!eksi tempat punsi
+ &erusakan struktur lokal* pl0 brachialis
+ False aneurisma ( arteri dgn cavitas hematom)
+ Arterio venous !istula (arang)
-
7/24/2019 Kuliah Uro Ro
10/47
Ko"plikasi %auh(
. ;mboli trhombus
4 ;mboli udara5 "otton !iber embolus
6 8iseksi arteri (oleh uide 23 "ath3 "%)
&urangi* + unakan < uide =ire
+ unakan Pig tail cath+ $es ineksi "%
> "ath knotting (simpul)
? "ath impaction (nancap)
@ Putus uide =ire -acteriemia,#epticemia
-
7/24/2019 Kuliah Uro Ro
11/47
aRenalis
-
7/24/2019 Kuliah Uro Ro
12/47
P$A
-
7/24/2019 Kuliah Uro Ro
13/47
g$r
-
7/24/2019 Kuliah Uro Ro
14/47
-
7/24/2019 Kuliah Uro Ro
15/47
Arah )u$-spesialis radiologi "asa depan*
%odalitas (alat)* U#3 "$3 %RI
#istem 7rgan* Uroradiologi3 'euro radiologi3
muskuloskeletal dsbUsia p0* pediatric radiologi B geriatric
radiologi dsb
-
7/24/2019 Kuliah Uro Ro
16/47
Gin%al
&elainan4
$umor
&ongenital-atu B kalsi!ikasi
$rauma
In!eksi
-
7/24/2019 Kuliah Uro Ro
17/47
Tu"or
-
7/24/2019 Kuliah Uro Ro
18/47
Tu"or +inak
:;%A'I7%A
+
-
7/24/2019 Kuliah Uro Ro
19/47
Poly,ysti, kidney
Usia D 6E thn
-
7/24/2019 Kuliah Uro Ro
20/47
Kongenital
;ctopic kidney
Renal Agenesis
Renal dysplasia
Renal :ypoplasia
%alrotated &idney
Renal 8uplication
:orse shoe kidney
-
7/24/2019 Kuliah Uro Ro
21/47
-
7/24/2019 Kuliah Uro Ro
22/47
atu Gin%al &.ephrolithiasis'
Asimptomatis
&olik renal,ureter
:ematuria3 hypertensi3 I#ingle3 multiple3 #taghorn calculi
Ro* -'73 IVP3 U#3 "$ #can3 AP
-
7/24/2019 Kuliah Uro Ro
23/47
Trau"a Gin%al
$rauma* taam3 tumpul
&linis * :ematuria3 nyeri3 akut abdomen
$eraba massa
+
$rauma Ringan* &ontusio3 mengenai korteks tanpalaserasi kaliks atau kapsul renalis
+ $rauma #edang* Ruptur kapsul3 caly0 masih utuh3ruptur caly0 dan capsul3 a renalis sobekPerdarahan dan ekstravasasi urine sub capsuler
+ $rauma -erat* Avulsi a renalis dan trombosis arenalis
+ Ro * -'73 IVP3 "$ #can3 U#3 Arteriogra!i renalis
-
7/24/2019 Kuliah Uro Ro
24/47
-
7/24/2019 Kuliah Uro Ro
25/47
-
7/24/2019 Kuliah Uro Ro
26/47
-
7/24/2019 Kuliah Uro Ro
27/47
-
7/24/2019 Kuliah Uro Ro
28/47
Infeksi ginjal
Pyelonephritis AcutEtiologi : Infeksi acendens
IVP : Normal,ginjal membesar,
neprogaram
USG : Membesar, intensitas eco !"
#$ Scan: Membesar, densitas !,
batas corte% & med'lla kab'r,distorsicali%"
-
7/24/2019 Kuliah Uro Ro
29/47
Infeksi ginjal
Abses Ginjal(sal : ) infeksi asending,
) t% tak adek'at p*elonepitis ak't,) ematogen"
IVP : massa focal+dif's *g menggeserpeliocal*ceal"
USG : massa *poecoic dg internal eco"
#$ Scan : massa densitas renda, dgkontras: ring enanced"
-
7/24/2019 Kuliah Uro Ro
30/47
Infeksi ginjal
Pyelonephritis kronisInfeksi ginjal ok bakteri
-enis . t*pe :
) /bstr'ktif
) Non obstr'ktif
IVP : ginjal #ontracted
-
7/24/2019 Kuliah Uro Ro
31/47
TBC Ginjal
Pen*ebaran ematogen
IVP : caitas berdinding irreg'ler,strikt'r, *droneprosis &contracted & kalsi0kasi"
-
7/24/2019 Kuliah Uro Ro
32/47
Ureter
Sal'ran meng'b'ngkan pelis renalis danVU
Panjang .1 & .2 cm,
3'a bagian : pars abdominalis, pelic
(da 4 pen*empitan :
) UP-
) Persilangan a" iliaca e%terna+com'nis) UV-
-
7/24/2019 Kuliah Uro Ro
33/47
Ureter
56 : IVP, 5etrograde + antegrade'reterop*elogra0
7E8(IN(N :
9" #ongenital :3'plikasi,Ureterocele,Strikt'ra,diertikel"
." at' : 5adio)opa;'e, radiol'cen4" Uretritis
-
7/24/2019 Kuliah Uro Ro
34/47
Vesica Urinaria
/rgan e%tra peritoneal, kapasitas VU .??).1? cc
56 : @P(, Sistogra0, IVP, USG, #$ Scan,(ngiogra0"
-
7/24/2019 Kuliah Uro Ro
35/47
Vesica Urinaria
Kelainan2
)7ongenital
Ekstropia b'li
Sistocele
ladder d'plication
Uracal anomalies
)at'at' b'li)b'li AVesicolitiasisB
)$ra'ma
5'pt'r b'li
-
7/24/2019 Kuliah Uro Ro
36/47
VESI#/8I$CI(SIS
jenis: 5adio)opa;'e, radiol'sen
56 : #*stogra0, sistoscop*
NEU5/GENI# 8(33E5
7elainan 3i #orda spinalis
Inkontinensia, retensi 'rine
VU : Spasme, besar Apin treeB
-
7/24/2019 Kuliah Uro Ro
37/47
Vesica Urinaria
$UM/5 G(N(S P5IME5
8eiomiosarcoma, 5abdomiosarcoma,@ibrosarcoma, osteosarcoma,
kondrosarcoma,angiosarcoma,liposarcoma"
$UM/5 -IN(7 : polip
56 : #*stoscop*, IVP A 0lling defect B,
USG massa di dinding b'li , #$ Scan"
-
7/24/2019 Kuliah Uro Ro
38/47
Vesica Urinaria
EN3( (SING
Pada anak, psikotik
56 : @P(, USG, #*stogra0
3IVE5$I7E8
-
7/24/2019 Kuliah Uro Ro
39/47
-
7/24/2019 Kuliah Uro Ro
40/47
-
7/24/2019 Kuliah Uro Ro
41/47
-
7/24/2019 Kuliah Uro Ro
42/47
-
7/24/2019 Kuliah Uro Ro
43/47
Urethra
56 : Uretrogra0, retrograde 'retroc*stogra0,oiding c*sto 'retrogra0
Kelainan 2 7/NGENI$(8 : diertikel, strikt're, d'plikasi,
S$5I7$U5(: akibat radang, tra'ma
@IS$E8: Uretroperineal A'retro)c'tanB, ok
keganasan , iatrogenik dll($U
$UM/5 : -inak , ganas, metastasis
-
7/24/2019 Kuliah Uro Ro
44/47
-
7/24/2019 Kuliah Uro Ro
45/47
-
7/24/2019 Kuliah Uro Ro
46/47
-
7/24/2019 Kuliah Uro Ro
47/47
Teri"akasih