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is the use of X‐rays to view unseen or
Drh. Deni Noviana, Ph.D
Staf Bagian Bedah dan Radiologi
Fakultas Kedokteran Hewan IPB
E‐mail: deni@ipb.ac.id
http://deni.staff.ipb.ac.id/
• Radiograph merupakan gambaran karya seni 2
dimensi hasil dari suatu organ/struktur yang
tadinya 3 dimensi
dimensi,
• Gambaran 3 dimensi dapat diimajinasikan dari
gambaran 2 dimensi yang diambil dengan sudut
pandang yang tepat.
• Imajinasi 3 dimensi di”dapatkan” dengan
menggunakan hasil pengambilan 2 gambar
standar radiografi
hard‐to‐image objects and is used for both medical and
industrial applications
is an X‐ray image
of the internal structure of an object.
is a healthcare professional who
creates medical images of the body to help health care
providers diagnose and treat illness and injury
a unit of measurement for ionizing radiation
an alternative name
for X‐rays
• Digantung pada iluminator dengan prosedur standar
dan pola tetap yang telah ditentukan sebelumnya
• Hasil pengambilan radiograf lateral, bagian kranial
diletakkan di sisi kiri
• Hasil pengambilan radiograf VD/DV, bagian kranial
pasien di letakkan di atas, sedangkan bagian kiri pasien
diletakkan di kanan
• Kondisi lingkungan yang tenang, pencahayaan
iluminator
iluminator yang cukup
cukup, kurangi cahaya
cahaya ruangan yang
yang
tidak perlu, fokuskan lesio organ pada titik tertentu
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• Setiap bayangan yang muncul harus dievaluasi

dan dijelaskan, apakah:
yBentukan
y normal
normalanatomi
yPecahan/ serpihan struktur dari struktur yang
bertumpuk/ superimpos
yArtefak dari kesalahan posisi
yLesio pathologi

Contoh langkah interpretasi yang baik dan benar

Gambar standar pandang pada Berdasarkan arah datangnya

pengambilan foto sinar‐x
sinar X, standar pandang yang
umum dipakai untuk regio
abdomen:
• Latero‐lateral (LL)Æ Lateral
• Ventro‐dorsal (VD)
• Dorso‐ventral (DV)
• Decubitus lateral

Contoh langkah interpretasi yang salah

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• Radiografi lateral pada

regio abdomen :
• Right recumbency lebih sering
ƒ Evaluasi radiografik abdomen Standar pandang
digunakan, dapat memperlihatkan
¾ Rasa sakit pada regio abdominal 1. Lateral
ujung limpa
¾ Gangguan gastrointestinal seperti anorexia, vomit, • Left recumbency memiliki
nausea atau diarrhea. keunggulan tersendiri yaitu
¾ Gangguan traktus urinaria seperti hematuria, dysuria, membuat gas dalam lambung dapat
strauria, perubahan frekuensi urine atau calculi VU 2. VD berpindah ke pylorus dan duodenum
atau ureter. • Kaki depan diposisikan secranial
¾ Gangguan traktus genitalia seperti discharge dari mungkin, dan kaki belakang secaudal
vulva mungkin.
¾ Evaluasi pada kebengkakan/masa abdomen • Standar pandang lateral dengan
3. DV
¾ Evaluasi distensi abdomen, tenesmus posisi hewan berdiri dan arah sinar X
horizontal Æ untuk deteksi cairan
dalam peritoneum.

• Radiografi VD/DV pada

regio abdomen :
• VD lebih baik daripada DV
Standar pandang
• DV cenderung menekan viscera yang
1. Lateral • Anjing: Pusat penyinaran Æ kira‐kira pada
menyebabkan perpindahan organ
• Posisi VD akan membantu t l
tulang t khi dan pertengahan
costae terakhir t h antarat
penyebaran luas normal organ‐organ umbilicus dan tulang belakang lumbalis.
dalam rongga abdomen
2. VD • VD sulit dilakukan pada hewan • Kucing: Pusat penyinaran Æ kira‐kira 2 jari di
trauma pada pelvis atau kaki belakang tulang costae terakhir dan
belakang , karena tidak dapat pertengahan antara umbilicus dan tulang
dilakukan penarikan
• Kaki depan diposisikan secranial
belakang lumbalis.
3. DV
mungkin, dan kaki belakang secaudal
mungkin.

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Posisi Radiografi Lateral Abdomen

Protocol :
1. Appropriate cassette should be selected
2. Cranial boundaries Æ entire diaphragm
3. Caudal boundaries Æ throchanter mayor femur
4. Dorsal and ventral boundaries (lateral view)Æ
soft tissue margins of the abdomen.
5. Medial and lateral boundaries (DV or VD view)Æ
soft tissue margins of the abdomen

Posisi Radiografi VD Abdomen

• Perbedaan kerapatan atau density antara satu

organ dengan organ lainnya
• Banyaknya lemak dalam abdomen
• Pergerakan pasien atau hewan selama
pemotretan
• Ketebalan hewan

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L3

• The gross anatomy of the abdomen are

not exactly the same with radiographic Zone 1
anatomy (ex: uterus) Zone 4

• Think about the relationships of organs Zone 3 Zone 5

• The abdomen divided into five zones on

lateral view and four zones on VD view. Zone 2

Zone 2
Zone 1
Zone 1
L3 • Liver (Right & caudate)
• Stomach (Fundus, body)
• Right kidney
Zo ne 1 • Pancreas*
Zone 3
• Mesenteric lymph node*
• Spleen & right adrenal*
Zone 2
Zone 4 • Liver
• Stomach (Body, pylorus)
Zo ne 2 • Pancreas*
• Gall bladder*
• Mesenteric lymph node*

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• Spleen (Body,
Zone 1 L3
• Liver (Right) tail).
• Stomach
• Proximal
P i l duodenum
d d
Zone 1 Zone 2
intestine
• Right kidney
• Right adrenal gland*
Zone 1
•Zone
Large
4 intestine
L1
• Pancreas*
• Mesenteric lymph node*
• Left kidney
Zone 5
• Gall bladder*
Zone 2
• Pancreas*
• Liver (Left)
• Stomach
• Left ovary
Zone 2
• Spleen (Head)
• Left adrenal gland*
• Uterus*

Zone 1 Zone 2

• Stomach* Zone 4
L3
• Colon & Rectum
• Small intestine L1
• Medial iliac lymph Zone 4
• Large intestine nodes*
• Left kidney • Ureters
Zone 3
• Pancreas* Zone 5
• Right and left ovaries* • Urinary bladder
• Ureter
• Uterus (cranial • Uterus Zone 3 Zone 5

horns)* Zone 4
• Prostate gland

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• Colon/rectum Zone 5
L3
• Ureter • Urinary bladder
Zone 4
• Uterus
Zone Ureter
L5
• Uterus
• Urinary bladder
• Prostate gland (M)
• Medial iliac lymph Zone 4
nodes*
Prostate (M) Zone 3 Zone 5

• Rectal lymph node

• Hewan dipuasakan selama

18‐24 jam
Pemeriksaan radiografi lambung dengan • Hewan diberi obat sedasi
menggunakan bahan kontras untuk acepromazine 0,1 mg/kg BB
mengetahui struktur lambung IM dan dibius Ketamin 10%
15‐20 mg/kgBB (*opt)
Bahan kontras dibagi 3 macam : • Bahan kontras barium sulfat
1.Bahan Kontras Positif : Barium Sulfat dan Iodium 30% 10 ml/kgBB dicampur
/ tablet
1/8 bl effervecent (*(*opt),
2.Bahan Kontras Negatif : Udara, Carbondioksida, Nitrit Oksida
dimasukkan ke lambung
3.Double Kontras : Gabungan kontras positif dan negatif melalui stomach tube.

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ÎkVp : Lateral 50, DV‐VD 52

ÎmAs abdomen 2.5 (Screen 400)
ÎPengambilan X‐ray:
• Sebelum menit ke‐5 dengan posisi left lateral
untuk melihat cardiac lambung, BaSO4 for 0 minute BaSO4 for 1 minute

• Pada menit ke‐10 dengan posisi right lateral

dan DV untuk pemeriksaan pylorus lambung,
• Pada menit ke‐2020 dengan posisi
posisi VD
• Pada menit ke‐60 dengan posisi VD dan L‐
Lateral. BaSO4 for 30 minute BaSO4 for 60 minute

1. Hewan di puasakan selama 12‐

Metode pemberian bahan kontras untuk
menghasilkan struktur gambar ginjal yang jelas 24 jam
Bagian Pyelum ginjal 2. Hewan dibius Î Î
Melalui Vena Perifer (V. Cephalica antibrachii ACP/Acepromazine, Dosis: 0,02‐
Dorsalis, V.Saphena) atau Vena Jugularis 0,1 mg/kg BB IM/SC) + Ketamin
10%, Dosis: 15‐20 mg/kg BB
Bahan kontras ÎTri‐Iodine (Iohexol®) (*opt)
Meglumine
M l i diatrizole® ® 3. Tehnik P k abdomen
T h ik ÎPenekanan
Sodium diatrizoat® 4. Penyuntikan Intra Vena Î
ÎSifat: Soluble (terlarut) Menggunakan IV‐Catether

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Iodine for 5 minutes Iodine for 15 minutes Iodine for 25 minutes Positive Contras Double Contras Negative Contras

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• Largest gland in the body. • Axis stomach is parallel to the ribs.

• Soft tissue opacity and lies in the cranial
abdomen, diaphragm and
abdomen caudal the diaphragm and cranial
cranial • Caudal margin is enclosed within the rib cage
stomach.
or very close to costae margin.
• Divided into four lobes: left, right, caudate and
quadrate.
• Normal liver size is emperical Æ both views must
be used. Æ Dog Æ Cat
• Position of the stomach Æ aids in the
determination of liver size.

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Hati
NORMAL LIVER HEPATOMEGALY MICROHEPATIA
Hati

• Normal size: extremely variable.

• Associated with right liver lobes.
• Soft tissue opacity.
• Not normally visualized.
• Changes might be visualized: mineral
opacities, gas opacities
• In dog > cat.
• Drugs such as barbiturate, ACP Æ generilized splenic
enlargement.
• Proximal extremity (head of the spleen) Æ connected to
the gastric fundus.
• Proximal extremity (body) Æ located in the left dorsal
aspect (Lateral zone 1/VD zone 2).
• Distal
highlyextremity (tail) Æ located in the ventral abdomen,
variable location
highly variable location.
• the exact size triangular
Radiographs: of spleen is much larger.
soft‐tissue opacities Æ remember

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• Not visualized radiographically , except enlarged

• Ultrasound is excellent tool to evaluate.
• Medial iliac lymph nodes (ventral L6 in zone 4).
• Mesenteric lymph nodes (zone 3).
• Inguinal lymph nodes (ventral flank, outside
abdominal cavity).

• Not visualized radiographically , except

• Located in the retroperitoneal space.
enlarged.
• Ultrasound
Ult d is more useful tool to
t evaluate. • Cranial pole of the RK is often difficult to
visualize Æ superimposed with the liver.
• The right limb lies adjacent and caudal to the
• LK more caudal than RK, and its location more
caudal margin of stomach.
variable.
• The left limb lies medial and adjacent to the
• Size in dog: 2.5‐3.5 times the length of L2 (rec:
descending duodenum. VD view).
• Radiographic identification of pancreatic
disease is difficult. • Size ini cat: 2.4‐3.0 times the length of L2 (rec:
VD view).

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R. Kidney
L. Kidney

VU

GINJAL ANJING: 2,5-3,5 KALI PANJANG VERTEBRAE LUMBALIS KE-2 GINJAL KUCING: 2 KALI PANJANG VERTEBRAE LUMBALIS KE-2

• Located in the retroperitoneal space.

• Not normally visualized on radiographs.
• Using iv contrast medium Æ max diameter 2‐3
mm.

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PR

PR M
M

VU
VU

Aplikasi IVP (intra venous

pyelogram) dengan bahan kontras Aplikasi IVP (intra venous pyelogram) dengan
positif terionisasi preparat iodine, bahan kontras positif terionisasi preparat
15 menit. iodine, 5 menit.

• The size is highly variable. • Male: comprises three parts.

• If empty Æ may not be visible.
• May be located either to the left or to the
right of midline, or centered (VD view).
• Prostatic Æ confined to the prostate gland.
• Membranous Æ extends from the prostate to
the os penis.
• Penile Æ shorter in cat than in dog.
• Female: the urethra is shorter and wider.

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Positif kontras cystogram dilkakukan dengan mengaplikasikan media kontras secara

retrograde ke dalam kantung kemih

• Not visualized radiographically, except • Not visualized radiographically , except

l d
enlarged l d or gravid.
enlarged id
• Normal prostate diameter: max 2/3 the width • Stump is located between the bladder and
of the pelvic inlet on VD view. colon.
• Normal prostate in cat is not visible. • Gravid: fetal skeletons become visibe at day
• Prostatic disease in the cat is very rare. 45.

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• Lies caudal to the liver and cranial to
transverse colon.
• The axis parallel to the ribs.
• Dog: pylorus is generally to the right of
midline.
• Cat: pylorus is generally on midline or slightly
to the left of midline.
• The size and opacity is extremely variable.
Located at the mid abdomen
Dog : Normal SI should be no wider than the
central portion of the body lumbar
vertebrae and it should not exceed the
diameter of twice the width of a rib.
Cat : Gas accumulation are typicaly lest than
in normal dog.

Cecum : Located to the right of midline on Ascending colon : Is to the right of midline.
VD view andd in the
th central abdomen
bd Tranverse colon : At the hepatic flexure, the
on lateral view. ascending colon turns to the left
and continues across the midline to
Dog : It has a C‐Shaped appereance. the left.
Cat seen
: Very small and usually not seen. Desending colon : At the splenic flexure, the
colon turns caudaly and continues in
to the pelvic canal.

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Pylorus
Fundus Fundus
Caecum

Duodenum Colon Desc Tranv. col

Asc. col

desc. col

Pylorus

GINJAL

KOLON
FUNDUS

COSTAE

FEMUR

PYLORUS
DUODENUM
USUS HALUS

ABDOMEN (120 MENIT KONTRAS POSITIF)

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