Tentir Radiologi Resti-Deef

7/30/2019 Tentir Radiologi Resti-Deef

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TENTIR RADIOLOGI

KEPALA & SISTEM SARAF



SINAR XTampak Frontal Tampak Lateral

• ethmoid sinuses (E), frontal sinus (F), orbital roof (O), superior surface of the petrous portion of the temporal bone (P), sphenoid ridge (S), coronalsuture (C), dens (D), anterior clinoid process (AC), dorsum sella (DS), sella

turcica (ST), lambdoid suture (L), inner table of calvarium (IT), outer tableof calvarium (OT), and sphenoid sinus (SS).



CT SCAN



CT-Scan Normal intracranial

• Ganglia Basal

• white matter(left internal

capsule)• cerebrospinal

fluid (CSF;frontal horn of

the left lateralventricle

• bone (skull)







MRI



NormalSagittal T1-weighted axial T1-weighted



axial T2-weighted• Keterangan

– gray matter (large arrows)

– white matter (curved arrows)

– CSF (small arrowheads) – fat (small arrows)

– cortical bone (large arrowheads)

– genu (g) and

– splenium (s) of the

– corpus callosum (cc), – fornix (f),

– optic chiasm (oc),

– pituitary gland (pit),

– midbrain (mb),

–pons (p), medulla (m),

– cerebellar vermis (Cb),

– straight sinus (SS),

– caudate head (c)

– putamen (pt)

–thalamus (T)



Kasus 1• A 47-year-old female presents with diabetes mellitus

and recent development of left-sided hemiplegia.

• Axial images from an uninfused head CT examination

• Area hipodens di

sebelah kanan MCA

(Middle Cerebral Artery)

•Parenkim terdesak kekiri

Trombus Akut pd

pembuluh darah(main trunk of MCA)



In case 1, what is the most likely diagnosis?

a. Intracranial abscess

b. Arachnoid cystc. Metastatic brain tumor

d. Primary brain tumor

e. Cerebral infarction



Kasus 2 • A 66-year-old woman presents with gradual onset of nausea, dizziness, and ataxia. The patient becamecomatose 24 hours after the onset of symptoms.

• Axial T2-weighted and sagittal T1-weighted images

Edema pd

Serebelum

• Ventrikel 4 terdesak

• Batang otak terdesak

•

Herniasi tonsilar



In Case 2, what is the likely cause of the

patient's problem?

a. Brain stem infarction

b. Brain stem compression from cerebellar

infarction

c. Brain stem tumor

d. Cerebellar astrocytoma

e. Posterior fossa hemorrhage



Kasus 3• A 42-year-old female hypertensive renal transplant patient

presents with acute mental status changes and lefthemiparesis.

• A single axial image from a noncontrast head CT scan

• In case 1, what is themost likelydiagnosis?

a. Thalamic gliomab. Subarachnoid

hemorrhage

c. Metastatic disease

d. Hypertensivehemorrhage in thebasal ganglia

e. Cerebral contusion• Ganglia Basal Hematoma

•

Ekstensi intraventrikular• Bergesernya struktur tengah



KASUS 4• A 33-year-old Hispanic man presents with a syncopal

episode and involuntary tremors.

• Noncontrast sagittal T1-weighted and axial T2-weightedimages, as well as postcontrast axial T1-weighted images

• Masa terlihatHeterogen

• Terdapat

pseudocapsul

• Setelah diberi

kontras terlihat

lapisan meningen

(dura)

Meningioma

• Masa terlihat Homogen

dg parenkim otak



• In Case 4, what is the most likely diagnosis?

a. Extra-axial brain tumor

b. Intra-axial brain tumor

c. Frontal contusion

d. Subdural hematoma

e. Encephalocele



Kasus 5• A 48-year-old woman presents with a history of

headaches and seizures.

• Initial coronal T2-weighted FLAIR and axial contrast-enhanced T1-weighted images

• Hiperintens di inferior frontal regions & right temporal lobe dan perluasan ke corpus calosum

•

Enhancement sudah mencapai hemisper kanan dan sebagian badan corpus calosum.• Pada kasus ini terlihat seperti tumor ganas (anaplastic oligodendroglioma)



• In case 5, what is the most likely cause of the

patient's symptoms?

a. Multiple sclerosis

b. Inner ear abnormality

c. Intraventricular meningioma

d. Hematoma

e. Malignant brain tumor



Kasus 6

• In Case 6, the major differentialdiagnosis for this lesion is

toxoplasmosis versus??

a. cryptococcus.

b. intracranial lymphoma.

c. sarcoidosis.d. metastatic disease.

e. cytomegalovirus (CMV).

• A 43-year-old man (With HIV) presents withheadache and weakness.

• An axial contrast-enhanced T1-weighted MR image

•

Lesi (enhancement) yg multiple,termasuk di daerah ganglia basal

• Lesi seperti ini biasanya terdapat pd

orang dg HIV yg terinfeksi toksoplasma /

terbentuknya limfoma intrakranial.



Kasus 7• A young man who has been in a motor vehicle

accident presents with a head injury.

• Soft-tissue window from an axial non-contrast headCT scan

• What is the diagnosis?a. Subdural hematoma

b. Cerebral contusion

c. Epidural hematoma

d. Meningioma

e. Subdural hygroma

The biconvex

(cembung) appearanceof this lesion is typical

of an epidural

hematoma

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Tentir Radiologi Resti-Deef