Kuliah Neoro Radiologi Revisi

8/20/2019 Kuliah Neoro Radiologi Revisi

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Tengkorak dan CNSTen

gkorak dan CNS

• 1.Foto standart projection

• a.Foto PA & Lateral

• b.Towne’s utk

fossa pos.• c.Basis, utk lihat

basis cr.

• . . !T "can

Ten#korak dpt dilihat d#. $. Arterio#ra%

• . 'uclear scinti#ra%• (. )ltrasono#ra%

• * . +-

• . Pneu/oencephalo#ra%


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"ella Tursica

• 'or/al 0

• a a 11 2 1* //

• b 3 2 1 //

• b "ella tursica, pada or.dewasa bbtk

• kantun#.

• 4elainan2 0 "/all sella2

/5otonia con#• 62shape77shoe7hour #lassseperti

• pada #a/bar spt berikut


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"ella Tursica


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4elainan tersebut bisa terjadi pada (8anak2anak den#an #lio/a optic atau

chronic h5drocephalus.

"utura di#unakan utuk /elihattekanan intra cranial.

9an# dilihat Fontanella

Fontanella /a5or Fontanella/inor

/enutup $ 2 * bln /enutup1( 2 13 bln


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Kalsifikasi Normal

Intrakranial.


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4alsi%kasi

'or/al


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Gambaran Skull abnormal dengan kepala kecil

Turri cephali Brachi cephali

Dolicho cephalipntpan bgn blkng pntpn bgn lateralpntpn bgn depan


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+aca/2/aca/ btk

craniu/


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Macam-macam kelainannya.

1. Craniostenosis bisa beru"a /

a. 0rigonoe"!ali meto"i sutura

b. a"!oe"!ali sagital sutura

. Plagioe"!ali "d lambdoid dan oronal sutura

d. 4iroe"!ali seluru! sutura menutu"$immature

2. acunar skull, "ada alvaria tam"ak t!umb "rint$ etakan ibu jari

Pada anak-2 bisa krn raniostenosis

!. "laty basia, bentuk basis ranii mendatar, tdk tm"k &ossa ranii ant, media

mau"un "osterior.

#. $asillar impression &ossa ranii "osterior naik ke atas.

%. &ypertelorisme jarak orbita kanan ( kiri +ang lebar


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&ydrocep)alus

"enutu"an bisa di

oramen 4onro 67uadut +lvii

oramen 4agendi

Pada orang de8asa tekanan intra ranial da"at dili!at dari /

"roessus linoideusant.

Kelainan sella tursia "roessus linoideus

"ost.


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HydrocephalusA *(25ear2old /an presented withpro#ressi:e de/entia. "e;uentiala.


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+enin#itis Axial contrast-enhanced T1W MR

image in a neonate with group Bstreptococcal meningitis shows

extensive leptomeningeal exudates at

the inferior frontal and anterior

temporal regions (arrows

Axial contrast-enhanced T1W MR image

in a child with acute p!ogenic meningitis

reveals enhancing leptomeningeal

exudates over "ilateral cere"ral

convexities (arrows#


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)kuran 4epala


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Kelainan pada *aringanotak

Crbral injuries CVA Degen.disease Inflam.

Tumor

Cerebral injuries /e"idural bleeding, subdural bleeding,

!+groma, !erniasi, "erdr!n ou" (

ontra ou".

Cerebro vascular desease Stroke

Cerebral in&artion Cerebral !aemorr!age


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Degenerative disease

!erebral atroph5e/5elinatin# disease

Infamation

ncephalitis !erebral abscess

Tuberculo/a To


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!erebral

atroph5 A


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e/5elinatin# disease

Axial proton densit!$weighted MR%

demonstrates multiple lesions in a

distri"ution characteristic of multiplesclerosis# &pecificall!' the

periventricular lesions and the more

peripheral white matter lesions near

the gra! matter$white matter unction

are t!pical MR% findings in multiplesclerosis#


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Neoplasma :

1. +enin#io/a (.+edulloblasto/a

. Astroc5to/a *. 'eurino/a

$. Eli#odendro#lio/a .!raniophar5n#io/a

. lioblasto/a


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Kelainan "ada jaringan otak


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Tu/or otak


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Kelainan "ada jaringan otak


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Tu/or otak


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Meningioma (Brain)

)efinition*

Meningothelial or arachnoidal cellneoplasm usuall! attached to the

dura


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Pilocytic Astrocytoma (Pediatric

Brain)

+ere"ellar piloc!tic

astroc!toma# +oronal T,-

weighted MR image shows "oth

the solid (h!pointense (arrows

and c!stic (h!perintense


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Medulloblastoma (Pediatric

Brain)

MR% of medullo"lastoma#

&agittal T1-weighted image

shows h!pointense mass in

the fourth ventricle#

MR% of medullo"lastoma# Axial T,-weighted image

shows h!percellular

mass with central c!st

(arrow#


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+ere"ral %nur!


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pidural he/ato/a

&u"dural hematoma with adacent

su"arachnoid hemorrhage was

the result of a ruptured middle

cere"ral arter! aneur!sm# Aneur!sms are unusual causes of

ate su"acute-to-chronic

su"dural hematoma with a

"lood-fluid level indicating acute

hemorrhage into the chronic

collection#


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pidural Ge/ato/a

+T scanning performed "efore

and after surgical evacuation of

an intracranial epidural

hematoma

This MR% demonstrates

spinal epidural hematoma#


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"udural he/ato/a

Axial T1-weighted magnetic resonance

imaging demonstrates "ilateral su"acute

su"dural hematomas with increased signal

intensit!# Areas of intermediate intensit!

represent more acute hemorrhage into thesu"acute collections#

&u"acute su"dural hematoma withextension into the anterior

interhemispheric cistern# .ote that

the sutures do not contain the spread

of these hemorrhages#


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Pemeriksaan Myelografi


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-ntra cranial he/orrha#e

This +T scan and MR% revealed mid"rain

intracere"ral hemorrhage (%+/ and

intraventricular hemorrhage (%0/ associated with

a cavernous angioma

%ntracranial hemorrhage# +T scan of right

frontal intracere"ral hemorrhagecomplicating throm"ol!sis of an ischemic

stroe#


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Kelainan pada jaringan otak


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Neuro Radiology of the Spine. Pemeriksaannya bisa dengan :

1. Plain X-ray photo AP, Lateral atau Oblique

2. CT Scan

3. MRI

4. Myelography, caudography

5. Spinal angiography

6. Radio isotop scanning

7. USG


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$entukan abnormal dari spine +

6. Pada tulang . Pada 9isus inter.vert.

1.Kelainan ongenital 1. Keradangan

2. Keradangan 2. H:P$!ernia nuleus

"ul"osus.

3. 0umor

%. 9egenerative "roess

5. 0rauma


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Kelainan Medula Spinalis.

1. Kelainan o.k. HNP

2. Spinal canal stenosis

3. Meningocele

4. Tumor :

a. Intra medullary b. Intraduralc. Ekstradural


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Spondylolisthesis

)egenerative

spond!lolisthesis#

&agittal T,-weightedscan shows a grade 1

spond!lolisthesis of 2

on 3 and h!pertroph! of

the ligamentum flavum

posteriorl! (arrows

&pond!lol!sis with

spond!lolisthesis# A lateral plain

film of the lum"osacral unctionconfirms discontinuit! of the

pars interarticularis at 3

(arrow and a grade %

spond!lolisthesis at 3-&1#

&pond!lol!sis with

spond!lolisthesis#

&agittal T,-weighted imagediscloses a grade 1

spond!lolisthesis of 3 on

&1 and widening of the

anteroposterior dimension of

the spinal canal at that level#


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Myelography


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Myelography


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Myelography


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Myelography


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Tu/or pada /edula spinalis


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Tumor metastasis

&pinal cord metastasis in a female patient nown to have

"reast cancer


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Tu/or pada /edulaspinalis

T!pical meningioma (white arrows

on sagittal T,-weighted MR image

presents as isointensit! on T,-

weighted imaging

4lio"lastoma multiforme (4BM#

&agittal T,-weighted MR image of

the cervical spine demonstrates an

extensive cervical thoracic

glio"lastoma multiforme#


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Kuliah Neoro Radiologi Revisi