医学影像学教学大纲(七年制)二

医学影像学教学大纲（七年制）二第二章中枢神经系统一、目的与要求.了解颅脑和脊髓的检查方法；.熟悉颅脑和脊髓的X线、CT和MRI正常解剖；.掌握颅脑和脊髓的基本病变的影像学表现，尤其CT、MRI表现;.掌握常见颅内肿瘤、脑血管疾病、外伤、常见感染性疾病的影像学表现；.熟悉脊髓疾病的影像学表现。二、教学内容第一节检查方法1．颅脑（1）X线检查：平片、血管造影；（2）CT检查：平扫、增强、CTA以及CT灌注扫描;（3）MRI检查：侧重常规序列的讲解，简单介绍功能成像。2．脊髓（1）X线平片：常规正侧位；（2）脊髓造影：了解适应症；（3）CT检查：平扫、增强以及脊髓造影CT（CTM）；MRI检查：侧重常规序列的讲解，简单介绍MR脊髓成像(MRM)。第二节正常影像解剖1．头颅平片的正常表现和变异，侧重讲述颅缝、囟门、颅壁压迹、蝶鞍的表现；.颅脑CT、MRI横断面正常表现；.脊髓CT、MRI正常表现。第三节基本病变的影像学表现1．颅脑(1)平片：侧重讲解颅内压增高、颅内肿瘤定位征象；CT和MRI：分别讲解颅内病变的病灶显示、强化表现、脑水肿、占位效应、脑积水和脑萎缩的表现；.椎管内肿瘤简单介绍X线平片和脊髓造影的表现。第四节颅内肿瘤1．神经胶质瘤：熟悉星形细胞瘤、少突胶质细胞瘤和髓母细胞瘤的临床和病理表现，掌握其CT和MRI征象。.脑膜瘤：熟悉其临床和病理表现，掌握CT和MRI征象。.垂体腺瘤：了解其分类和临床表现，掌握微腺瘤和大腺瘤的CT和MRI特点。.颅咽管瘤：熟悉其好发部位、病理特点以及CT、MRI诊断依据。.生殖细胞瘤：熟悉其好发部位、病理特点以及CT、MRI诊断依据。.听神经瘤：熟悉其病理改变，掌握CT和MRI表现，了解桥小脑角占位的鉴别诊断。.血管母细胞瘤：了解其病理特点，熟悉CT和MRI表现。.脑转移瘤：熟悉其临床和病理表现，掌握CT和MRI特点。第五节脑血管疾病.脑梗死：结合动脉性脑梗死后的病理生理改变，重点掌握常规CT和MRI表现；熟悉腔隙性脑梗死和出血性脑梗死的CT和MRI诊断要点。.脑出血：结合脑出血不同时期的病理改变，着重讲述常规CT和MRI表现；.结合病例，熟悉蛛网膜下腔出血、动静脉畸形、动脉瘤的CT、MRI、DSA的表现。第六节颅脑外伤.硬膜外血肿：了解本病的发生机理、病理改变，掌握其CT和MRI表现。.硬膜下血肿：了解本病的发生机理、病理改变，掌握其CT和MRI表现。.脑挫裂伤：了解本病的发生机理、病理改变，掌握其CT和MRI表现。.弥漫性轴索损伤：自学。第七节颅内感染性疾病.化脓性脑脓肿：了解发病机制、病理表现，掌握其CT、MRI典型表现。.颅内结核：熟悉CT、MRI表现。.病毒性脑炎：自学内容。.脑囊虫病：自学内容。第八节脱髓鞘疾病本节简单介绍多发性硬化的影像学表现。第九节颅脑先天性畸形及发育障碍本节为自学内容。第十节脊髓疾病结合病例，介绍常见的脊髓内肿瘤（室管膜瘤、星形细胞瘤）、髓外硬膜下肿瘤（神经鞘瘤、神经纤维瘤、脊膜瘤）的CT和MRI表现。脊髓损伤、脊髓空洞症为自学内容。三、实验内容与要求通过示教片了解中枢神经系统的平片、造影检查、CT和MRI检查方法；通过示教片熟悉颅脑和脊髓平片、C^MRI正常影像；熟悉颅脑和脊髓异常表现；11通过示教片掌握神经胶质瘤、脑膜瘤、垂体腺瘤、听神经瘤、脑转移瘤、脑梗死、脑出血、颅脑外伤、化脓性脑脓肿、脊髓内肿瘤、髓外硬膜下肿瘤的影像学表现。熟悉颅咽管瘤、生殖细胞瘤、血管母细胞瘤、蛛网膜下隙出血、动静脉畸形、动脉瘤、颅内结核、脊髓空洞症的影像学表现。四、教学时数分配理论课学时分配章节理论课内容学时第二章第一节第二节检查方法颅脑正常影像表现脊髓正常影像表现1第二章第三节颅脑基本病变的影像学表现椎管内肿瘤的基本影像学表现第二章第四节颅内肿瘤：侧重讲解神经胶质瘤、脑膜瘤、垂体腺瘤、听神经瘤、脑转移瘤；简单介绍颅咽管瘤、生殖细胞瘤、血管母细胞瘤11第二章第五节脑血管疾病：重点讲解脑梗死、脑出血；简单介绍蛛网膜下隙出血、动静脉畸形、动脉瘤11第二章第六节颅脑外伤：重点讲解硬膜外血肿、硬膜下血肿和脑挫裂伤1第二章第七节颅内感染性疾病：重点讲授化脓性脑脓肿，简单介绍颅内结核、病毒性脑炎1第二章第八节第二章第十节脱髓鞘疾病：简单介绍分类和多发性硬化脊髓疾病：重点讲解椎管内肿瘤1总学时9实验课学时分配序号实习课内容实验类型学时1读片内容：颅脑、脊髓正常表现：基本病变；颅内肿瘤的影像学表现演示性实验22读片内容：脑血管疾病、脑外伤、脑感染性疾病以及脱髓鞘疾病；椎管内肿瘤演示性实验24思考题.颅内压增高的X线诊断？.星形细胞瘤的组织学分级和CT、MRI表现？.脑膜瘤的CT和MRI诊断要点？.垂体大腺瘤的MRI表现？.常见的桥小脑角区肿瘤的CT和MRI鉴别诊断？.缺血性脑梗死的CT和MRI表现？.不同时期脑出血的MRI信号特点？.硬膜外血肿和硬膜下血肿的CT鉴别诊断？Chapter2Centralnervoussystem一、Requirement.Comprehendexaminationmethodsforbrainandspinalcord..Conversantwithnormalanatomyappearanceofbrainandspinalcordinx-ray,CTandMRI..Masterimageappearanceofbasicdiseaseinbrainandspinalcord,especiallyCTandMRIones..Masterimageappearanceofcommonintracranialtumors,cerebrovasculardisease,traumaandcommoninfectivedisease..Conversantwithimageappearanceofspinaldisease.二、TeachingContentSection1Examinationmethod1.Brainx-ray:plainfilmandangiography（comprehend）CT:allexaminationtechnique（comprehend）MRI:emphasizeonconventionalsequenceandsimplypresentfunctionalMRI2.Spine（1）X-rayplainfilm：posterior-anteriorandlateralpositionisroutine.（2）Spinalmyelography（3）CT：plainscan,contrastscanandCTmyelography（CTM）；（4）MRI：emphasizeonconventionalsequenceandsimplypresentMRmyelography.NormalimaginganatomyNormalappearanceandvarianceinskullplainfilm,emphasisoncranialsuture,fontanelles,impressionofcranialboneandsellaturcicaCTandMRIsectionalanatomyofbrainNormalappearanceofspinalcordinCTandMRIImageappearanceofbasicdisease1.Brain（1）Plainfilm:locationsymptomofincreasedintracranialpressureandbraintumors（2）CTandMRI：displayinglesions,enhancementappearance,cranialedema,commonmasseffect,hydrocephalusandbrainatrophy.ntraspinaltumorsComprehendimageappearanceofx-rayfilmandmyelography.Intracranialtumors.Gliomas：Mastermainmanifestationofastrocytoma,oligodendrogliomaandmedulloblastomainCTandMRIafterbefamiliarwiththeirclinicandpathologicfindings..Meningioma：MastermainsigninCTandMRIafterbefamiliarwiththeirclinicandpathologicfindings..Pituitaryadenoma：FirstcomprehenditsclassandclinicfindingsandthenmastermaincharacteristicsinCTandMRI..Craniopharynioma：Befamiliarwithitscommonposition,pathologiccharacteristicsanddiagnosispointsinCTandMRI..Germinoma：Befamiliarwithitscommonposition,pathologiccharacteranddiagnosispointsinCTandMRI..Acousticneurinoma：Befamiliarwithitspathologiccharacteristics,masterCTandMRImanifestation,andthencomprehenddifferentiatingdiagnosisoftumorsincerebral-pontinalanglearea..Hemangioblastoma：ComprehenditspathologiccharacterandknowwellCTandMRIfindings..Metastatictumors：BefamiliarwithitsclinicandpathologicfindingsandmasteritsCTandMRIcharacter.Cerebrovasculardisease.Cerebralinfarction:Combiningphysiologicpathologyofcerebralischemiaresultingfromthrombosisofcerebralartery,emphaseonconventionalimageappearance,andthenknowwelldiagnosticpointsoflacunarinfarctionandhemorrhagicinfarctioninCTandMRIscans..Cerebralhemorrhage:Combiningpathologicalvariationindifferentperiods,emphaseonimageappearanceofCTandMRI..Combiningcases,introducecharacteristicsaboutsubarachnoidspacehemorrhage,arteriovenousmalformationandintracranialaneurysminCTMRIandDSA.InjuryofskullandbrainCombiningpathogenisiswithpathology,introduceimageappearanceespeciallytheCTscansofepiduralhematoma,subduralhematomaandcontusionandlacerationofbrain.Intracranialinfectivedisease1．Cerebralabscess：MastertypicalimageappearanceofinCTandMRI2．Cranialtuberculosis：BefamiliarwithCTandMRImanifestation.DemyelinatingdiseaseIntroducesimplytheimagingappearanceofmultiplesclerosis.CranialcongenitalmalformationSelf-culture.SpinalcorddiseaseCombiningcases,introducecharacteristicsaboutependymatoma,astrocytoma,neurinoma,neurofibromaandmeningiomainCTandMRI.ExperimentContentandRequirementUnderstandingimagingmethodsbyreadingfilm.Understandingthenormalmanifestationsandbasicabnormalfindingsofbrainandspineinplainfilm,CTandMRIbyreadingfilm.Masteringtheimagingfindingsofglioma,meningioma,pituitaryadenoma,acousticneurinoma,metastatictumors,infarction,hemorrhage,trauma,abscess,intraspinaltumorsandsubedrualtumorsbyreadingfilm.Beingfamiliarwithcraniopharynioma,germinoma,hemangioblastoma,sudarachnoidhemorrhage,aterio-venousmalformation,aneurysm,tuberculosisandsyringomyeliabyreadingfilm.CourseplanTheorylessonChapterContentsTimeTwo-One-TwoImagingmethodsNormalimaginganatomyofbrainandspine1Two-ThreeBasalabnormalappearanceofbrainandspine1Two-FourCranialtumors:glioma,meningioma,pituitaryadenoma,acousticneurinoma,metastatictumors2Two-Fivecerebrovasculardiseases:cerebralinfarction,hemorrhage2Two-SixBraintrauma:epiduralhematoma,subduralhematoma,lacerationandcontusionofbrain1Two-SevenCranialinfectivediseases:brainabscess1Two-Eight-TenDemyelinatingdiseases:MultiplesclerosisSpinaldiseases1Alltogether9ExperimentlessonNumberContentsCategoryTime1Readingfilmscontents:Normalimaginganatomyandbasalabnormalappearanceofbrainandspine,cranialtumorsDemonstrating22Readingfilmscontents:cerebrovasculardiseases,braintrauma,Cranialinfectivediseases,DemyelinatingdiseasesandSpinaldiseasesDemonstrating2Alltogether4Questions1．WhatisthelocationsymptomofincreasedintracranialpressureinX-rayplainfilm?2．WhatisthehistologicalclassificationandCTandMRIappearanceofastrocytoma?3．WhatisthediagnosticpointofmeningiomainCTandMRI?4．WhatistheMRIfindingsifpituitaryadenoma?5．Whatisthedifferentiatingdiagnosisofcommontumorsincerebral-pontinalanglearea?6．WhatisthetypicalmanifestationofischemiainfarctioninCTandMRI?7．Combiningpathologicalvariationindifferentperiods,presentMRIintensitycharacteristics?8．DifferentiatingdiagnosisbetweenepiduralandsubduralhematomainCT?第三章头