Ary

 Sasongko  
Staff  Radiologi  Diagnos/k  dan  Pencitraan  Kardiovaskular  
RS  Jantung  &  Pembuluh  Darah  Harapan  Kita  -­‐  Jakarta  
Rela%ng  to  the  circulatory  system,  
which  comprises  the  heart  and  blood  
vessels  and  carries  nutrients  and  
oxygen  to  the  %ssues  of  the  body  and  
removes  carbon  dioxide  and  other  
wastes  from  them  
(h<ps://www.medicinenet.com/script/main/art.asp?
ar%clekey=18311)  
Medical   imaging  
refers   to   several   different   technologies  
that  are  used  to  view  the  human  body  in  
order   to   diagnose,   monitor,   or   treat  
medical   condi%ons.   Each   type   of  
technology   gives   different   informa%on  
about   the   area   of   the   body   being   studied  
or   treated,   related   to   possible   disease,  
injury,   or   the   effec%veness   of   medical  
treatment.  
Radiology Modalities :
 
-­‐  Computed  Radiography/  Digital  Radiography  
-­‐  Computed  Tomography-­‐Scanning  (CT-­‐Scan)  
-­‐  Nuclear  Medicine  
-­‐  Ultrasound  
-­‐  Magne%c  Resonance  Imaging  MRI)  
Sifat-­‐sifat  Sinar-­‐X  
 
1.  Daya  tembus  (êMassa  Atom  éDaya  Tembus)  
2.  Panjang  gelombang  yang  pendek  
3.  Efek  Photografi  
4.  Efek  Ionisasi  
5.  Efek  Biologi  
 
Mul/  Purpose  Radiography/  General  
Radiography  

•  Digunakan  untuk  hampir  semua  pemeriksaan  

standar  Radiologi    

•  Misalnya  :  pemeriksaan  ortopedi,  thorax,  

abdomen,  kepala,  tulang  belakang  dan  lain-­‐lain  
Mobile  Radiography  
 
•  Digunakan  untuk  jenis  pemeriksaan  yang  
dilakukan  di  luar  ruangan  Radiologi  

•  Misalnya  :  pemeriksaan  ortopedi,  thorax,  

abdomen,  kepala,  tulang  belakang  dan  lain-­‐lain  
What  CT-­‐Scan  Can  See..??  
 
-­‐  Broken  bones  (skull,  ribs,  extremi%es)  
-­‐  Blood  clots  in  the  brain  and  chest  
-­‐  Abnormali%es  of  the  lungs,  such  as  pneumonia  
-­‐  Inflamma%on  in  the  abdomen  (such  as  appendici%s  or  
gallblader  disease)  
-­‐  Stones  (in  the  gallblader  or  kidney)  
-­‐  Cancer  in  various  organs  and  body  parts  
-­‐  Cardiovascular  disease  
 
•  1  Tesla  =  10,000  Gauss  
 
•  Low-­‐Field  MRI=  Under  0.2  Tesla  (2,000  Gauss)  
 
•  Mid-­‐Field  MRI=  0.2  -­‐  0.6  Tesla  (2,000  -­‐  6,000  Gauss)  
 
•  High-­‐Field  MRI=  1.0  -­‐  1.5  Tesla  (10,000  -­‐  15,000  
Gauss)  


 WHAT  IS  MAGNETIC  FIELD?  

•  Magne/c  field  is  measured  in  Tesla.  

 
•  MRI  Machine  =  1.5  Tesla  
 
•  Earth  =  0.00005  Tesla.  
 

•  MR  is  30,000  X  stronger  than  the  EARTH’s  

magne/c  field.  
 
 
•  Memanfaatkan  atom  Hidrogen  dalam  tubuh    
•  Atom  bergerak  secara  acak  dalam  tubuh    
•  Tubuh  yang  mengandung  atom  tersebut  dimasukan  ke  dalam  
medan  magnet  kuat  
•  Atom  yang  bergerak  secara  acak  kemudian  berubah  arah  
mengiku%  arah  medan  magnet  
•  Diberikan  Radiofrekuensi  sampai  arah  atom  tersebut  %dak  
searah    dengan  arah  medan  magnet  
•  Radiofrekuensi  dihen%kan  dan  atom-­‐atom  kembali  ke  arah  
semula  mengiku%  arah  magnet  
•  Ke%ka  atom-­‐atom  kembali  ke  posisi  arah  magnet,  
mengeluarkan  energi  (pulse)  
•  Energi  tersebut  di  proses  oleh  komputer  sehiingga  meghasilkan  
gambar  organ  tubuh  yang  diinginkan  
•  Anatomical  imaging  
•  Measuring  physiological  func%on  
•  Flow  measurements  and  angiography  
•  Tissue  perfusion  studies  
•  Tumor  
 Warning…!!  
The  CMR  scanner  can  have  the  following  effects  that  may  
endanger  pa%ents  or  staff  in  the  magnet  room  :  
 
 
1.  Missile  effects:  The  scanner  will  a<ract  any  ferromagne%c  objects  with  enormous  force.  This  force  is  
higher  the  closer  one  gets  to  the  magnet  bore.  Non-­‐MR-­‐compa%ble  metallic  objects  like  scissors  or  
oxygen  cylinders  can  become  deadly  missiles.  
 
2.  Displacement:  Metallic  objects  in  the  body  such  as  shrapnel,  aneurysm  clips,  etc.,  may  be  moved  by  the  
magne%c  field  and  cause  injury.  

3.  Internal  devices:  The  magne%c  field  can  have  torque  effects  on  implanted  ac%ve  devices  such  as  cardiac  
pacemakers  or  insulin  pumps,  causing  them  to  change  their  secngs  or  malfunc%on.  

4.  Hea9ng  effects:  During  scanning,  the  radiofrequency  field  can  cause  hea%ng  of  devices,  cables,  and  
wires  that  are  either  adjacent  to  the  pa%ent  (e.g.  non-­‐MR-­‐compa%ble  ECG  cables)  or  implanted  (e.g.  
pacing  wires),  with  the  poten%al  to  cause  serious  burns.  
GENERAL MISCONCEPTIONS ABOUT
THE MAGNETIC FIELD
—  If the system is switched OFF, then the
magnetic field will also be off. X
—  This is a big object. The magnet is not strong
enough to pull it. X

—  This is a small object. Not necessary to

remove from patient or my pocket. X
 GENERAL KNOWLEDGE ABOUT THE
MAGNETIC FIELD’S EFFECT

—  The Magnetic field is very strong. It can pull

objects up to hundreds of kilograms.

—  A 1.0kg iron object will feel like almost

100kg inside a 1.5 TESLA magnetic field.
 GENERAL KNOWLEDGE ABOUT THE
MAGNETIC FIELD’S EFFECT

—  Big objects will cause serious injuries or

even death to the people who are around or
inside the Magnet.

—  Small sharp objects will also cause serious

injuries or even death to the people around
or inside the Magnet.
MRI  EATS  BED….  
Boy,  6,  Killed  in  Freak  MRI  Accident  
July  31,  2001  
A  6-­‐year-­‐old  boy  died  aher  undergoing  an  MRI  exam  at  a  New  York-­‐area  hospital  when  the  
machine's  powerful  magne%c  field  jerked  a  metal  oxygen  tank  across  the  room,  crushing  the  
child's  head.    
 
The  force  of  the  device's  10-­‐ton  magnet  is  about  30,000  %mes  as  powerful  as  Earth's  
magne%c  field,  and  200  %mes  stronger  than  a  common  refrigerator  magnet.    
 
The  canister  fractured  the  skull  and  injured  the  brain  of  the  young  pa%ent,  Michael  
Colombini,  of  Croton-­‐On-­‐Hudson,  N.Y.,  during  the  procedure  Friday.  He  died  of  the  injuries  
on  Sunday,  the  hospital  said.    
 
The  rou%ne  imaging  procedure  was  performed  aher  Colombini  underwent  surgery  for  a  
benign  brain  tumor  last  week.  Westchester  Medical  Center  officials  said  he  was  under  
seda%on  at  the  %me  of  the  deadly  accident.    
 
Hospital  Takes  ‘Full  Responsibility’    
 
FIRST FATAL MRI
ACCIDENT
 Two employees were
stuck to the MRI
machine for four hours
after one of them
walked into the room
with an oxygen
cylinder
Nov 11, 2014,
TATA MEMORIAL
HOSPITAL, MUMBAI,
INDIA
The ward boy fractures
his arm, while his
colleague sustains
serious injuries,
including a punctured
urinary bladder and
severe internal
bleeding.
 Uttar Pradesh:
Minister’s guard
carries gun during
MRI scan, ruins
machine
Ø  During the scan at Dr.
Ram Manohar Lohia
Institute of Medical
Sciences in Lucknow,
his pistol was pulled
from his body and got
stuck on the machine.
Ø  According to reports,
the cost of repairing
the 5-crore machine
will come around Rs
40-50 lakh.
Ø  Jun 03, 2017
LV  2  Chamber  Cine  
Short  Axis  View  
4  Chamber  Cine  
 LGE/DE  
(Late  Gadolinium  Enhancement/Delayed  Enhancement)