PENGGUNAAN PROYEKSI LPO PADA PEMERIKSAAN BNO IVP DENGAN KLINIS HIDRONEFROSIS DI INSTALASI RADIOLOGI RS PKU MUHAMMADIYAH WONOSOBO
DOI:
https://doi.org/10.51878/healthy.v5i4.14419Keywords:
BNO-IVP, Hidronefrosis, Left Posterior Oblique, Double Collecting System, RadiografiAbstract
ABSTRACT
BNO-Intravenous Pyelography (BNO-IVP) in hydronephrosis requires appropriate projection and examination timing to obtain optimal diagnostic information. Procedural modifications may be necessary based on radiographic findings and anatomical conditions. This study aimed to describe the BNO-IVP procedure in hydronephrosis cases and analyze the considerations for using the Left Posterior Oblique (LPO) projection and extending examination time. This descriptive qualitative study used an observational case study approach at the Radiology Department of RS PKU Muhammadiyah Wonosobo. Data were collected through observation, semi-structured interviews, and documentation involving two patients with hydronephrosis and four informants consisting of three radiographers and one radiologist. Data were analyzed descriptively by comparing observations, interviews, documentation, and relevant theory. The BNO-IVP procedure included plain abdominal radiography, contrast administration, sequential radiographs, and post-micturition imaging. In one patient, LPO projection was performed at 15 minutes due to suspected double collecting system. The projection helped reduce ureteral superimposition and improve visualization of the urinary tract anatomy. In the other patient, examination was extended to 120 minutes due to delayed contrast excretion. These findings indicate that projection and examination-time modifications were adjusted based on radiographic findings and patient conditions to obtain more optimal diagnostic information. LPO may be used as an additional projection in suspected double collecting system or specific anatomical abnormalities, while extending the examination time may be performed in cases of delayed contrast excretion.
ABSTRAK
Pemeriksaan BNO-Intravenous Pyelography (BNO-IVP) pada kasus hidronefrosis memerlukan pemilihan proyeksi dan waktu pemeriksaan yang tepat untuk memperoleh informasi diagnostik yang optimal. Modifikasi prosedur dapat diperlukan berdasarkan temuan radiograf dan kondisi anatomi pasien. Penelitian ini bertujuan mendeskripsikan prosedur pemeriksaan BNO-IVP pada kasus hidronefrosis serta menganalisis pertimbangan penggunaan proyeksi Left Posterior Oblique (LPO) dan penambahan waktu pemeriksaan. Penelitian kualitatif deskriptif dengan pendekatan studi kasus observasional dilakukan di Instalasi Radiologi RS PKU Muhammadiyah Wonosobo. Data diperoleh melalui observasi, wawancara semi-terstruktur, dan dokumentasi terhadap dua pasien hidronefrosis dengan empat informan yang terdiri atas tiga radiografer dan satu dokter spesialis radiologi. Data dianalisis secara deskriptif melalui perbandingan hasil observasi, wawancara, dokumentasi, dan teori yang relevan. Hasil penelitian menunjukkan prosedur BNO-IVP meliputi foto polos abdomen, pemberian media kontras, pengambilan radiograf secara bertahap, dan pemeriksaan post-miksi. Pada satu pasien, proyeksi LPO dilakukan pada menit ke-15 karena dugaan double collecting system. Proyeksi tersebut mengurangi superposisi ureter dan memperjelas anatomi sistem urinaria. Pada pasien lainnya, pemeriksaan diperpanjang hingga menit ke-120 karena keterlambatan ekskresi media kontras. Modifikasi proyeksi dan waktu pemeriksaan dapat disesuaikan dengan temuan radiograf dan kebutuhan diagnostik pasien. Proyeksi LPO dapat dipertimbangkan sebagai proyeksi tambahan pada dugaan double collecting system atau kelainan anatomi tertentu untuk meningkatkan informasi diagnostik.
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