Presentasi X-Ray (Fluoroscopy)

5/24/2018 Presentasi X-Ray (Fluoroscopy)

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X-Ray (Fluoroscopy)

Toni (36386)

Bobby Rian Dewangga (37994)

Richard Aritonang (38539)Muhammad Qodar Abdurrahman (38939)


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Outline

Definisi X-Ray Floroscopy

Sejarah Fluoroscopy

Komponen Fluoroscopy

Cara Kerja Fluoroscopy

Kegunaan Fluoroscopy

Prosedur Fluoroscopy

Contoh Hasil Fluoroscopy

Kelebihan

Kekurangan


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Definisi X-RayDefinisi :

X-rays are part of the electromagnetic

spectrum, with wavelengths shorter than

visible light. Different applications use different

parts of the X-ray spectrum.


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Definisi Fluoroscopy

Definisi :

Fluoroscopy is a diagnostic imaging technique that employs X-rays for

obtaining real-time moving imagery of the internal structure of a patient

through the use of a fluoroscope.


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History of X-RayFluoroscopy


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William Crookes (English)

(1869-1875)

A Crookes tube (2 views): light and dark.Electrons travel in straight lines from the

cathode (left), as evidenced by the shadow

cast from the Maltese cross on the

fluorescence of the right hand end. The

anode is at the bottom wire.


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Power off. Without magnet, rays

travel straight.

With magnet, rays

are bent down.

Diagram showing a Crookes

tube circuit.

Experimental electrical discharge tube, with partial

vacuum.

In which cathode rays, streams of electrons, were

discovered.

Crookes tube consists of a partially evacuated glass

container of various shapes, with two metal

electrodes, the cathode and the anode, one at either

end.

When a high voltage is applied between the

electrodes, cathode rays (electrons) are projected instraight lines from the cathode.


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Johann Hittorf - William Crookes

(1880s)

Found that photographic plates

placed near the tube became

unaccountably fogged or flawed by

shadows. Neither found the cause

nor investigated this effect.

Johann Hittorf

(German)

William Crookes

(English)


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Ivan Pulyui (Ukrainian)

(1877-1886)

Constructed various designsof vacuum discharge tube toinvestigate their properties.

1886 he found that sealedphotographic plates becamedark when exposed to theemanations from the tubes.

Early in 1896, just a few weeks after Rntgen published his first X-ray

photograph, Pulyui published high-quality X-ray images in journals in

Paris and London.


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Philipp Lenard (German)

(1888)

Conducted experiments to see whethercathode rays could pass out of the Crookes

tube into the air.

He built a Crookes tube (later called a "Lenard

tube") with a "window" in the end made of

thin aluminum, facing the cathode so the

cathode rays would strike it.

He found that something came through, that

would expose photographic plates and cause

fluorescence.

He measured the penetrating power of these

rays through various materials.

It has been suggested that at least some of

these "Lenard rays" were actually X-rays.


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Hermann von Helmholtz

(American)

Formulated mathematical equations

for X-rays.

He postulated a dispersion theory

before Rntgen made his discoveryand announcement.

It was formed on the basis of the

electromagnetic theory of light.

However, he did not work with actual

X-rays.
http://e/KULIAH/SEMESTER%208/2.%20Instrumentasi%20Biomedis/2.%20Setelah%20UTS/X-RAY-fluoroscopy/inti.htm


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Wilhelm Rntgen (German)

(1895)First medical X-ray

by Wilhelm Rontgen

of his wife Anna

Stumbled on X-rays while experimenting with

Lenardand Crookes tubesand began studying

them.

He wrote an initial report "On a new kind of

ray: A preliminary communication" and on

December 28, 1895 submitted it to the

Wrzburg's Physical-Medical Society journal.


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This was the first paper written on X-

rays.

Rntgen referred to the radiation as

"X", to indicate that it was an

unknown type of radiation.

The name stuck, although (over

Rntgen's great objections) many of

his colleagues suggested calling them

Rntgen rays.

They are still referred to as such in

many languages, including German,

Danish, Polish, Swedish, Finnish,Estonian, Russian, Japanese, Dutch,

and Norwegian.

Rntgen received the first Nobel

Prize in Physicsfor his discovery.


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Rntgen realized some invisible rays coming from the tube were passing

through the cardboard to make the screen glow.

He found they could also pass through books and papers on his desk.

Rntgen discovered its medical use when he made a picture of his wife's handon a photographic plate formed due to X-rays.

The photograph of his wife's hand was the first photograph of a human body

part using X-rays.

When she saw the picture, she said "I have seen my death.


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Wilhelm Trendelenburg

(1916)

As the earlier fluorescent screensproduced limited light, the earlierradiologists were needed to be in adark room where they used to adjusttheir vision to the darkness andincrease their light sensitivity.

The radiologist was also exposed tosignificant amounts of radiation ashe used to sit behind the screen.

The problem of adjusting vision todarkness was solved when WilhelmTrendelenburg developed redadaptation goggles in the year 1916.


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Westinghouse

(1940s)

The practice of fluoroscopy was revolutionizedwhen Westinghouse developed X-ray imageintensifier during the late 1940s and also whenclose circuit television cameras were introducedaround a decade later.

Image intensifiers could amplify the light

emanated from the fluorescent screen whichmade the images visible even in lighted rooms.

This made the red adaptation goggles obsolete.

The camera allowed viewing the images remotelyin a monitor and negated the risk of exposure toradiation.

The latest developments in image

intensifiers, screen phosphors and flat

panel detectors have enabled

physicians to obtain more high quality

images and have minimized the

chances of the patient being exposed

to harmful radiation.

The modern fluoroscopy machines

employ CSI screens and generate

noise-limited images, making sure that

minimum amount of radiation produceoptimum quality of images.


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Komponen Fluoroscopy


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Komponen Utama Flouroskopi

X-ray tube dan generator

Image Intensifier

Sistem Monitoring dan Video


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X-ray tube dan generator

Adalah tabung pembangkit sinar X untuk digunakan dalam flouroskopi.

Spesifikasi: Sinar X disinari lebih lama

0,5 5,0 mA

Menggunakan High frequency units Merupakan tabung berkapasitas tinggi (500.000

heat unit)


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Image Intensifier

Adalah sistem yang mengolah sehinggamendapatkan sinyal untuk mendapatkan gambaratau video yang diinginkan.

Prinsipnya: konversi low intensity full size image kehigh-intensity minified image.

Image Intensifier terdiri dari:

a. Detector

b. PTM ( Phase multiplier tube)


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http://3.bp.blogspot.com/-u1_hPMhvv_8/Ul9oxt9cx6I/AAAAAAAAAD4/VzENjOCxobo/s1600/t.jpg


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a. Detector

Terbuat dari crystals iodide (CsI) yang

mempunyai sifat memendarkan cahaya

apabila terkena radiasi sinar-X. Absorpsi

dari detektor sebesar 60% dari radiasisinar-X.


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b. PMT (Photo Multiplier Tube)

Terdiri dari :

Photokatoda Focusing Electroda

Anodedan Output Phospor


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Sistem Monitoring dan Video

Dikarenakan output phospor hanya berdiameter 1inch (2,54 cm), gambar yang dihasilkan relatif kecil,karena itu harus diperbesar dan di monitor oleh

sistem tambahan.

sistem penampil gambar ini mampu menampilkan

gambar bergerak secara langsung (Real-TimeViewing) dan beberapa yang lainnya untuk gambardiam (Static Image)


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Cara Kerja Fluoroscopy


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Fluoroscopy digunakan untuk membantu

diagnosis suatu penyakit atau memandu dokter

selama prosedur perawatan.

Barium X-Rays

Bedah orthopedi

Angiografi


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Prosedur Fluoroscopy


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Sebelum Prosedur Dilakukan

Dokter akan menjelaskan prosedur dan menawarkankesempatan untuk menanyakan bagian yang kurangjelas

Pasien akan diminta untuk menandatangani formulir

yang menyatakan persetujuan Anda.

Dokter akan memberitahu persiapan yang harusdilakukan sebelum prosedur dilakukan.

Memberitahu dokter apabila Anda pernah mempunyaireaksi terhadap zat kontras atau alergi terhadap iodine.

Pasien yang sedang/mungkin hamil harusmemberitahu dokter.


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Selama Prosedur Dilakukan

Pasien akan diminta untuk memakai baju

medis bila perlu dan/atau melepas perhiasan.

Substansi kontras bisa saja diberikan,

tergantung pada tipe prosedur yang dilakukan.

Anda akan diposisikan pada meja X-Ray bila

perlu.

Scanner X-Ray digunakan untuk memproduksi

citra fluoroskopik.


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Contoh Hasil Fluoroscopy


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Hasil Scan Fluoroscopy

Lower cervical vertebrae Fracture

Perbaikan acetabulum kanan

Hip Replacement


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Finger Angioma


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Normal ZenkersDiverticulum


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Kelebihan


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Benefit

Low Cost dibandingkan dengan MRI

Digunakan untuk menyelidiki pergerakan

suatu organ/sistem tubuh seperti dinamika

alat-alat peredaran darah, misalnya jantung

dan pembuluh darah besar; serta pernapasan

berupa pergerakan diafragma dan aerasi paru-

paru.

Digunakan untuk membantu proses kateter.


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Kekurangan


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Risk


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Risk

Radiation , dari luka bakar akibat radiasi

hingga kanker akibat radiasi.

Annual Radiation DoseLimits Agency

Radiation Worker - 50 mSv (NRC, "occupationally" exposed)

General Public - 1 mSv (NRC, member of the public)

General Public - 0.25 mSv (NRC, D&D all pathways)

General Public - 0.10 mSv (EPA, air pathway)General Public - 0.04 mSv (EPA, drinking-water pathway)


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Risk

Harga Alat bisa mencapai Rp. 180.000.000,00

Penggunaannya sulit, memerlukan

keterampilan khusus dan biasanya

operatornya sudah tersertifikasi.

Dosis Melampaui 20 Gy, Necrosis akan muncul

setelah 6-8 bulan akibat angiography dan angioplasty


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Risk


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Sesi tanya jawab:


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Nur wangsa Saputra

Apa kelebihan x-ray terhadap yang lain?

Kelebihanya adalah bisa melihat secara real time

sedang yang lain hanya berupa hasil scan

(gambar).


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Ridlo

Kenapa bisa hanya darahnya saja yang

kelihatan, tulangnya tidak kelihatan?

>


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Bayu

Kenapa efeknya muncu tidak secara langsung?

(beberapa hari atau beberapa bulan?)

Sel-sel berbeda sensitifitasnya

Untuk yang tidak terlalu sensitif maka efeknya

akan muncul dalam waktu yang lama.

Documents

Presentasi X-Ray (Fluoroscopy)