OPTIMISASI PEMERIKSAAN MRI BRAIN PADA KASUS STROKE ISKEMIK MENGGUNAKAN SEKUEN 3D TOF-MRA DI INSTALASI RADIOLOGI RSUD DR. SOEDONO MADIUN

Background : Ischemic stroke is an ischemic cerebrovascular disease that occurs when blood supply to the brain is suddenly disturbed by occlusion. There is a sequence difference that is used in MRI Brain examination of ischemic stroke cases between theories and sequences in Radiology Installation of RSUD dr.Soedono Madiun by axial T2 BLADE (FSE), axial T2 FLAIR, axial T1 FLASH (GRE), axial DWI, and 3D TOF-MRA. The purpose of this research is to know the procedure of MRI Brain examination, the reason for using 3D TOF-MRA sequence, and to know the optimization of MRI Brain examination protocol in case of ischemic stroke in Radiology Installation of RSUD dr.Soedono Madiun.Method : The type of this research is qualitative research with case study approach using observation method, interview, and documentation study. Data were analyzed by conducting interview transcripts, categorization tables, and coding charts.Result : The results showed that MRI brain examination procedure for ischemic stroke cases in accordance with hospital SPO. 3D TOF-MRA sequence used to analyze the anatomical and pathological arterial circle of willis without using contrast medium, scanning time is approximately 4.5 minutes which allows the movement of the patient and overcome by patient education, sequence repetition, and or using anesthesia. Optimization of the MRI examination in the case of Brain ischemic stroke with use of axial T2 BLADE sequence to evaluate a pathology in brain parenchyma, axial T2 FLAIR sequence to assess abnormalities that resemble the cerebro spinal fluid (CSF) such as edema, axial T1 FLASH sequence for anatomically assessing brain parenchyma (both also used on hemorrhagic strokes), the axial DWI sequence to evaluate the early stroke phase and determine the age of ischemic stroke by showing the restricted area of the cerebral parenchyma, and 3D TOF-MRA sequence to evaluate the anatomical and pathological arterial circle of willis.Conclusion : Based on the results of this study concluded that the use of sequences axial T2 BLADE (FSE), axial T2 FLAIR, axial T1 FLASH (GRE), axial DWI, and 3D TOF-MRA can be to optimize the MRI Brain examination in cases of ischemic stroke in producing an accurate diagnosis