TENTIRAN COASS, USG 23 JANUARI 2010

dewi widyasari
 Keuntungan
• Cepat
• Aman, non ionizing radiations.
• Non-invasif.
• Ketepatan diagn tinggi.
• Relatif murah.
 Keterbatasan
• Operator dependant
• Pasien gemuk.
• Udara/tulang.
 Persiapan pasien
• Abd – puasa 6-8 jam
• Ob-gy/pelvis – full bladder
• Endoscopic
• Jarang diperlukan sedasi
• Emergency – no preparations.
 Hepatic
Veins

Spleen
Celiac
axis

Liver
SMA Left
Right
Renal artery kidney
kidney
Renal vein
 FAST
1

2 4

3
RUQ view
 Normal RUQ

Liver

Kidney
 RUQ Fluid
Many Faces of Morrison’s Pouch!

Video
Many Faces of Morrison’s Pouch!
Many Faces of Morrison’s Pouch!
Many Faces of Morrison’s Pouch!
LUQ view
 Normal LUQ

Spleen

Kidney
 FF

Spleen

Kidney
Diaphragm
 Hemothorax

SP
FF KD
 Pleural Fluid

Video
Suprapubic View
 Bladder

Bladder
Uterus

Look here
for FF

Transverse View
 Bladder

FF

TRANSVERSE
 Pelvis Fluid

Video
 Superior Inferior

Longitudinal
LIVER TRAUMA
 ACOUSTIC SHADOWING

C. GALL STONES D. CALCIFIED PLAQUE IN AORTIC WALL

E. & F. TRANSVERSE & SAGITTAL SECTIONS OF RIGHT KIDNEY
SHOWING SMALL CALCULI.
Posterior enhancement

PE
The fluid contents are anechoic (red
arrow), the walls are thin and sharply
defined, and acoustic enhancement (E)
is evident deep to the cyst
Gallstone (red arrow) within the the
gallbladder produces a bright echo and
causes a dark acoustic shadow .
 Acute Cholecystitis: Major Criteria
(Gallstones & sonographic Murphy's
sign),Minor Criteria (Wall thickening > 3
mm & Pericholecystic fluid)

The gallbladder (GB) is filled with echogenic sludge (Sl) and a gallstone (red
arrow) is impacted in the gallbladder neck. The gallbladder wall (red
arrowheads) is markedly thickened indicative of wall edema and there are
pericholecystic fluid (blue arrows) pockets surrounding the gallbladder
LIVER ULTRASOUND
Renal Scanning Approaches
Medullary pyramids
Kidney Anatomy
Minor
Calyx

Major
Calyx

Sinus

Medulla

Renal capsule Cortex

Right Kidney Long Axis

Anterior

Superior Inferior
Liver
Sinus
Cortex
Diaphragm

Posterior
Right Kidney Short Axis

Anterior

Right GB Liver
Left
IVC

R Kidney
Vertebral
Aorta
Body Renal a.

Posterior
Left Kidney Long Axis

Anterior

Superior Inferior

Rib
Shadow

Kidney
Posterior
Spleen
Left Kidney Short Axis

Anterior

Right Liver Left

Spleen

L Kidney

Posterior
 Range of
Hydronephrosis

Normal Mild Moderate Severe

Renal Cysts

Liver
Scatter 20
Cyst Bowel

Kidney
Ultrasound of Kidneys

Kidney
Liver

Diaphragm
Rib
Shadow
Mass
 Renal Ultrasound

Right Kidney Left Kidney

Ultrasound

Echogenic
Structure

Distinct Shadow Thin Parenchyma

Dilated Calyces
AORTA
Longitudinal
Orientation

Marker
Transverse
Orientation

Marker
Orientation is similar to
that of a CT scan
Position probe is
perpendicular to long axis
of body or to long axis of
object that is being
Aorta
studied IVC,Liver
 SONOGRAPHIC APEARANCE OF
THE NORMAL AORTA: TRANSVERSE

Mid portion Bifurcation

SONOGRAPHIC APPEARANCE OF THE
NORMAL AORTA: LONGITUDINAL
Left: normal lung, Right: pleural effusion
Transverse image reveals normal appendix (between red arrows and +
cursors) and its echogenic submucosa (red arrowhead).
 APENDISITIS AKUT

GAMBAR 1 GAMBAR 2
 INTUSSUSCEPTION

GAMBAR 1 :

GAMBAR 2 :
TERIMA KASIH