Neuro Imaging in Psychiatri Dr. Benny

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Neuro Imaging in Psychiatry Benny Zulkarnien Dept. Radiologi

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Transcript of Neuro Imaging in Psychiatri Dr. Benny

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Neuro Imaging in Psychiatry

Benny ZulkarnienDept. Radiologi

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Neuro Imaging

Imejing fungsionalMRI Scan

fMRIDiffusion Tensor MRIMR spctroscopy (?)

SPECT ScanPET Scan

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MRI

MRI: Magnetic Resonance ImagingPrinsip dasar: menggunakan medan

magnet dan pergerakan inti atom H pada tubuh akibat stimulasi gelombang radio

Tidak menggunakan radiasiMemberikan detail jaringan lunak jauh

lebih baik dari CT scan

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MRI

Indikasisemua kelainan susunan saraf pusat intra

kranial maupun kanalis vertebralisKontra indikasi

absolut: pasien dengan protesis logamrelatif: claustrophobia

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MRI

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MRI

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MRI

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MRI

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MRI

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fMRI

fMRI: functional MRI merupakan pemeriksaan MRI yang didasarkan atas fungsi tertentu dari organ/ jaringan yang sedang diperiksa

fMRI pada neuroimaging terutama didasarkan pada aliran darah (blood flow) sesuai dengan aktifitas sel-sel/ jaringan

Menggunakan sekuens MRI yang disebut sebagai BOLD (blood oxygen level dependen)

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fMRI

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fMRI

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fMRI

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fMRI

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Diffusion Tensor MRI

DT MRI atau yang lebih dikenal sebagai MR tractography merupakan pemeriksaan yang berdasar pada proses difusi molekul air dalam jaringan

Memperlihatkan jaras saraf dan konektifitasnya dalam bentuk 3D

Dapat dikerjakan pada pasien Schizophrenia, gangguan kepribadian, gangguan bipolar, attention deficit disorder, obsessive-compulsive disorder, dan autisme

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DT MRI

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DT MRI

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DT MRI

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MR spectroscopy

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SPECT

SPECT: single photon emission computed tomography

Prinsip dasar: menggunakan sinar pengion

Sinar γ (gamma): gamma kameraDua gamma kamera melakukan rotasi

membentuk gambarSumber radiasi: tubuh pasien

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SPECT

Radiasi diperoleh dari radioisotopRadioisotop: a version of a chemical

element that has an unstable nucleus and emits radiation during its decay to a stable form.

Radiofarmaka: isotop yang dilabel (tagged) ke bentuk formulasi obat/zat kimia sebagai pembawa ke target organ

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SPECT

Isotop: Technetium 99

Materi pembawa (farmaka):MIBI HMPAOECD

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SPECT

Indikasi:gangguan perfusi susunan saraf pusatkeganasan

Kontra indikasi:absolut: kehamilan

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SPECT

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SPECT

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SPECT

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SPECT CT

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SPECT

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SPECT

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SPECT

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SPECT

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PET

PET: positron emission (computed) tomography

Prinsip dasar: menggunakan radiasi pengion

Mempunyai cara kerja yang hampir sama dengan SPECT

Detail dan akurasi jauh lebih tinggi di banding SPECT

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PET

Radioisotop/radiotracer:F 18O 15C 11N 13

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PET

Indikasisemua kelainan yang menyebabkan gangguan

fungsi intra kranialKontra indikasi

absolut: kehamilan

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PET

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PET

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PET

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PET

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PET

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PET

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Hybrid Imaging

Penggabungan structural imaging dengan functional imaging

Structural imaging: detail/resolusi tinggi fungsi organ/jaringan tak dapat diperlihatkan

Functional imaging: fungsi organ terdeteksi, resolusi rendah

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Hybrid Imaging

SPECT-CT

PET-CT

SPECT-MR

PET-MR

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Hybrid Imaging

Penggabungan bisa dilakukan post processing atau saat bersamaan

Hasil akhir memberikan gambaran functional imaging dengan detail anatomi

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Hybrid Imaging

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Hybrid Imaging

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Hybrid Imaging

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Hybrid Imaging

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SPECT MR

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