第七章 泌尿系统与肾上腺
一、目的与要求
1．了解肾、输尿管与膀胱检查技术；
2．熟悉肾、输尿管与膀胱的尿路造影、CT、MRI检查的正常表现；熟悉肾、输尿管与膀胱基本病变的尿路造影和CT表现；
3．掌握泌尿系结石、肾癌的CT和MRI表现；熟悉肾结核、肾囊肿与多囊性肾病、肾脏血管平滑肌脂肪瘤、膀胱癌CT和MRI表现。
4．自学肾上腺和肾上腺疾病。
二、教学内容
第一节 检查方法
1．X线检查：简单介绍X线平片、尿路造影（IVP、逆行性造影）、主动脉和肾动脉造影。
2．CT检查：了解CT平扫、增强扫描，简单介绍CTA的应用。
3．MRI检查：了解CT平扫、增强扫描，简单介绍MRU和MRA的应用。
第二节 正常影像解剖
1．X线检查：熟悉肾、输尿管与膀胱的正常尿路造影表现，了解腹部平片和逆行造影表现。
2．CT检查：熟悉肾、输尿管与膀胱CT平扫和增强扫描的正常表现，熟悉肾脏三期增强特点。
3．MRI检查：熟悉肾、输尿管与膀胱MRI平扫和增强扫描的正常表现。
第三节 基本病变影像学表现
1．X线检查：熟悉泌尿系统的尿路造影基本病变，了解腹部平片异常表现。
2．CT检查：熟悉肾、输尿管与膀胱的CT异常表现。
3．MRI检查：熟悉肾、输尿管与膀胱的MRI和MRU异常表现。
第四节 先天性发育异常
1．肾脏先天性发育异常：简单讲述肾缺如、异位肾、肾发育不全的CT表现和重复肾的造影表现。
2．自学输尿管与膀胱先天性发育异常。
第五节 泌尿系结石
1．肾结石：掌握肾结石的X线平片和CT表现，了解造影表现。
2．输尿管结石：掌握输尿管结石的X线平片和CT表现，了解造影表现和MRU特点。
3．膀胱结石：了解膀胱结石的影像学表现。
第六节 泌尿系结核
1．肾结核：熟悉肾结核的尿路造影和CT表现。
2．输尿管结核：了解输尿管结核的尿路造影、CT和MRU表现。
3．膀胱结核：了解膀胱结核的尿路造影和CT表现。
第七节 泌尿系囊肿与肿瘤
1．肾囊肿：熟悉肾囊肿、多囊肾的尿路造影、CT和MRI表现。
2．肾脏良性肿瘤：熟悉肾脏血管平滑肌脂肪瘤的CT和MRI特征。
3．肾脏恶性肿瘤：掌握肾癌的CT和MRI表现，熟悉其尿路造影表现；介绍肾盂癌和肾母细胞瘤的CT诊断。
4．膀胱肿瘤：熟悉膀胱癌的尿路造影、CT和MRI表现。
第八节 肾血管疾病：自学
第九节 肾外伤和肾移植：自学
第十节 肾上腺与肾上腺疾病：自学
思考题
1．MRU主要用于检查什么疾病？
2．如何在平片、尿路造影、CT和MRU上发现输尿管结石？
3．肾脏血管平滑肌脂肪瘤有什么的CT和MRI特点？
4．肾癌有何CT表现？
Chapter Seven Urinary System and Adrenal Gland
一、Learning Objectives
1. Knowing imaging modalities of the kidney, ureter, and bladder.
2. Being familiar with the normal imaging manifestations of kidney, ureter, and bladder. Being familiar with the basic abnormal appearances on urography and CT.
3. Mastering the manifestations of urinary calculus and renal carcinoma on CT and MRI. Being familiar with the imaging findings of renal tuberculosis, renal cyst and polycystic kidney, angiomyolipoma, and bladder carcinoma.
4. Self-studying adrenal gland and disease of adrenal gland.
二、Teaching Contents
Section One Imaging Methods
1. X-ray examination: To introduce plain X-ray, urography: (intravenous pyelograph, retrograde urography ), aortography, and renal arteriography.
2.CT examination: To describe plan and contrast CT. To briefly introduce CT angiography.
3.MRI examination: To describe plan and contrast MRI. To briefly introduce MRU and MR angiography.
Section Two Normal Imaging Anatomy
1. X-ray examination: Being familiar with the normal urography manifestations of kidney, ureter, and bladder. Knowing the findings on plain film and retrograde urography.
2. CT examination: Being familiar with the normal plain and contrast CT manifestations of kidney, ureter, and bladder. Being familiar with the characteristics of three-phase contrast enhancement of the kidneys.
3. MRI examination: Being familiar with the normal plain and contrast MRI manifestations of kidney, ureter, and bladder.
Section Three The Basic Abnormal Images
1. X-ray examination: Being familiar with the basic abnormal manifestations on urography. Knowing the findings on plain film.
2. CT examination: Being familiar with abnormal CT manifestations of kidney, ureter, and bladder.
3. MRI examination: Being familiar with abnormal MRI and MRU manifestations of kidney, ureter, and bladder.
Section Four Congenital Anomalies
1. Congenital anomalies of kidneys: To briefly introduce the CT findings of agenesis of kidney, ectopic kidney and aplastic kidney. To introduce urography of double kidneys.
2. Self-study congenital anomalies of ureter and bladder.
Section Five Urinary Calculus
1. Renal calculus: Mastering the manifestations of renal calculus on plain film and CT. To introduce urography of renal calculus.
2. Calculus of ureter: Mastering the manifestations of ureter calculus on plain film and CT. To introduce urography and MRU of renal calculus.
Section Six Tuberculosis of Urinary tract
1. Renal tuberculosis: To be familiar with the urography and CT findings.
2. Tuberculosis of ureter: To explain urography , CT and MRU findings.
3. Tuberculosis of bladder: To explain urography and CT findings.
4. Bladder calculus: To understand imaging findings of Bladder calculus.
Section Seven Cyst and Tumor of Urinary Tract
1. Renal cyst: To be familiar with the manifestations of simple cyst and polycystic kidney on urography, CT and MRI.
2. Benign tumors of kidney: To be familiar with CT and MRI features of angiomyolipoma.
3. Malignant tumors of kidney: To emphasize CT and MRI findings of renal carcinoma. To be familiar with the findings of renal carcinoma on urography. To introduce carcinoma of renal pelvis and Wilms turnor.
4. Tumor of bladder: To be familiar with the images of bladder carcinoma.
Section Eight Renal vascular diseases: Self-study.
Section Nine Renal trauma and transplantation: Self-study.
Section Ten Adrenal gland and disease of adrenal gland: Self-study.
Questions
1.What diseases can MRU be used to check?
2. How to find calculus of ureter on urography, CT and MRI?
3. What are the CT and MRI features of angiomyolipoma?
4. How to describe the CT characteristics of renal carcinoma?
三、实验内容与要求
通过示教片了解普通检查、造影检查、CT、MRI检查方法；
通过示教片了解胃肠道、肝、胆、胰、脾正常影像；熟悉胃肠道异常造影表现，了解肝、胆、胰、脾CT和MRI的异常表现；
通过示教片熟悉肾、输尿管与膀胱的尿路造影、CT、MRI检查的正常表现；熟悉肾、输尿管与膀胱基本病变的尿路造影和CT表现；
通过示教片掌握食管癌、溃疡病、胃癌、肝海绵状血管瘤、肝细胞癌、肝转移瘤、肝硬化、胆囊炎症和结石、胰腺癌、胰腺炎、肠梗阻、胃肠道穿孔、泌尿系结石和肾癌的影像学表现。
熟悉食管静脉曲张、结肠癌、肝脓肿、肝囊肿、胆道梗阻、脾外伤、肾结核、肾囊肿与多囊性肾病、肾脏血管平滑肌脂肪瘤以及膀胱癌的影像学表现。
Understanding imaging methods by reading film.
Understanding the normal imaging manifestations and basic abnormal findings of gastrointestinal tract and liver, biliary system, pancreas and spleen by reading film.
Understanding the normal imaging manifestations and the basic abnormal appearances of kidney, ureter, and bladder by reading film.
Mastering the imaging findings of esophageal carcinoma, digestive ulcer, gastric carcinoma, cavernous hemangioma of liver, hepatocellular carcinoma, hepatic metastases, cirrhosis of liver, cholecystitis and calculus, intestinal obstruction, gastrointestinal perforation, urinary calculus and renal carcinoma by reading film.
Being familiar with esophageal varices , carcinoma of colon, hepatic abscess, obstruction of biliary tract , spleen trauma, renal tuberculosis, renal cyst and polycystic kidney, angiomyolipoma, , and bladder carcinoma by reading film.
四、教学时数分配
（一）理论课学时分配
|
章 节 |
理 论 课 内 容 |
学 时 |
|
第六章第一节
第二节
第三节 |
检查方法
胃肠道正常影像和异常表现
肝胆胰脾正常影像和异常表现 |
1 |
|
第六章第四节
第五节 |
食管疾病：食管静脉曲张、食管癌
胃肠疾病：溃疡病、胃癌、结肠癌 |
1 |
|
第六章第六节 |
肝脏疾病：肝海绵状血管瘤、肝细胞癌、肝转移瘤、肝脓肿、肝囊肿、肝硬化 |
1.5 |
|
第六章第七节
第八节 |
胆道疾病：胆囊炎症和结石、胆道梗阻
胰腺疾病：胰腺癌、胰腺炎 |
1.5 |
|
第六章第九节
第十节 |
脾脏疾病：脾外伤
急腹症：肠梗阻、套叠、胃肠道穿孔、肠扭转、外伤 |
1 |
|
第七章第一节
第二节
第三节 |
检查方法
正常影像解剖
基本病变影像学表现 |
1 |
|
第七章第四节
第五节 |
发育异常：肾缺如、异位肾、肾发育不全、重复肾
泌尿系结石 |
1 |
|
第七章第六节 |
泌尿系结核
泌尿系囊肿与肿瘤：肾囊肿、血管平滑肌脂肪瘤、
肾癌、膀胱癌 |
1 |
|
总 学 时 |
9 |
|
Chapter |
Contents |
Time |
|
Six -One
- Two
- Three |
Imaging methods
Normal imaging anatomy and abnormal appearance
|
1 |
|
Six - Four
- Five |
Disease of esophagus
Disease of stomach and intestines |
1 |
|
Six - Six |
Diseases of the liver |
1.5 |
|
Six - Seven
- Eight |
Disease of biliary tract
Disease of pancreas |
1.5 |
|
Six - Nine
- Ten |
Disease of spleen
Acute abdomen |
1 |
|
Seven - One
- Two
- Three |
Imaging methods
Normal imaging anatomy
The basic abnormal images |
1 |
|
Seven - Four
- Five |
Congenital anomalies
Urinary calculus |
1 |
|
Seven - Six |
Tuberculosis of urinary tract
Cyst and tumor of urinary tract |
1 |
|
All together |
9 |
（二）实验课学时分配
|
序 号 |
实 习 课 内 容 |
实 验 类 型 |
学 时 |
|
1 |
食管、胃肠道、肝胆胰脾疾病读片 |
演示性实验 |
2 |
|
2 |
泌尿系统疾病读片 |
演示性实验 |
2 |
|
总 学 时 |
4 |
|
Number |
Contents |
Category |
Time |
|
1 |
Reading films of esophagus, gastrointestinal tract, liver, biliary tract, pancreas and spleen |
Demonstrating |
2 |
|
2 |
Reading films of Urinary Tract |
Demonstrating |
2 |
|
All together |
4 |