5th year Course Book/Radiology


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5th year Course Book/Radiology

  1. 1. Course Book Radiology for 5th Year Students of College of Medicine/ University of Sulaimani: 45 Lectures Course coordinator and list of teachers of this course .Name of the Course: Radiology -1 Lecturer tutor in charge: Dr. Ameer Ahmad -2 Department Branch and the college: Dept. Surgery/ college of -3 medicine/ University of Sulaimani :Contacts -4 .Address: University of Sulaimani/ College of medicine/ Dept - .of Surgery :amirkurda@yahoo.com-E-Mail :Website Link - Other participant - :Lecturers 1- Dr. Kawa Abdulla 2-Dr.Abeer Kadhum. 3-Dr.Salal Fatih Tel no. 07701473771 salahkalary@yahoo.com 4- Dr. Nasreen Atrooshi
  2. 2. Course Overview The student will be taught how to use the different imaging modalities properly & which imaging modality fits particular situation. The student should also learn how to read the radiographs of common clinical problems e.g. he or she should learn how to diagnose different fractures, pneumothorax, pneumonia, intestinal obstruction, pneumoperitoneum etc….. Not only that the graduated doctor should also learn how to read CT scan in patients with Stroke & head injury. Lastly the student should be taught about the update of Radiology & that radiology is no more used for diagnosis only, it is taking part in the therapy as well i.e. Interventional Radiology.
  3. 3. Reading lists: 1-Diagnostic Imaging …Peter Armstrong & Martin Wastie….. Sixth edition ……2009 2-Textbook of Radiology & Imaging …….David Sutton Seventh Edition….2003 3- Bailey & Love's Short Practice of Surgery 24th Edition…2004 2nd Chapter 4- WWW.LearningRadiology
  4. 4. Syllabus No. Title of the Subject Lecturer's/Tutor's Name 2 Introduction Dr.Ameer 7 Chest diseases Dr.Abeer 4 Cardio-vascular diseases Dr.Abeer 1 Plain abdomen Dr.Kawa 5 GIT Dr.Kawa 3 Hepato-biliary system Dr.Kawa Pancreas & spleen 2 Peritoneal cavity and Dr.Kawa Retroperitoneum 7 Urinary tract Dr.Nasreen 3 OBGYN Dr.Nasreen 4 Bone & joint diseases Dr.Salah 1 Bone Trauma Dr.Salah 2 Spine Dr.Ameer 2 Skull & Brain Dr.Ameer 1 Sinuses, orbits & Neck Dr.Ameer 1 Interventional Radiology Dr.Ameer 45 Total
  5. 5. Detail of Syllabus Two Lectures on Introduction & Technical Considerations: given by Dr. Ameer Objectives: -Proper use of imaging department. -How X-rays are produced in Conventional Radiography. Syllabus: -The basic radiographic densities. -Projections in conventional radiology:…PA. AP. Lateral, Horizontal X-ray beam, Lateral decubitus -CT Scan, Ultrasound, MRI, Radionuclide imaging & PET , Basic principles -Contrast agents in Conventional Radiography & CT.. Definition & side effects - PACS -Radiation Hazards Spine: Two Lectures given by Dr. Ameer Objectives: -Role of different imaging modalities in the diseases of the spine. (Plain radiographs, MRI, CT, Myelography)
  6. 6. Syllabus: -Signs of abnormality on plain films. -How metastases/ myeloma/ lymphoma appear on different imaging modalities and which one is the best. -Infection of spine; Pyogenic & TB spondylodiscitis. -Spinal Trauma. -Degenerative disc disease (DDD); plain film & MRI findings. -Disc herniation. -Failed back syndrome. -Spinal canal stenosis. -Ankylosing Spondylitis. -Spinal dysraphism. -Spondylolisthesis. -Spinal cord compression. -Intrinsic disorders of the spinal cord.. Skull & brain; 2 Lectures given by Dr. Ameer Objectives: -Role of different imaging modalities in head injury, Stroke, Brain tumors. Syllabus: -Plain film; normal & abnormal intra-cranial calcification. -Signs of raised intra-cranial pressure on Plain films.
  7. 7. -Normal & abnormal Brain CT. -Cardinal signs of abnormal CT brain. -CT angiography. -MRI of the brain. -MRA. -US of the Brain in neonates. -Brain Tumors; How common brain tumors appear by CT & MRI ? e.g. glioma. meningioma. acoustic neuroma, pituitary tumors & metastases. -Stroke Role of CT to exclude hemorrhage initially. -CT in subarachnoid hemorrhage.. -Role of CT in infarction. -Role of MRI in infarction. DWI. -AVM in MRI & MRA. -Infection & brain abscesses. -MS. -Head injury; Role of CT to show epidural, subdural & parenchymal hemorrhage. Contusion & fractures. Sinuses, Orbits & Neck one lecture by Dr. Ameer: Objectives -Role of Plain film & CT in sinusitis. -Different causes of opaque sinuses.
  8. 8. -Role of CT in blow out fracture. -Exophthalmus. -Diseases of Salivary glands & Role of plain radiograph, Sialography, CT & MRI. -Thyroid nodules; Role of US & radionuclide scan. Interventional Radiology: one Lecture by Dr. Ameer. Objectives To let the student know that Imaging has not only the role in diagnosis of diseases, but it can be of great help in treatment & may replace surgical procedures.: How can imaging guide biopsy? Draining abscesses? putting stents & e.g biliary drainage ? . Different interventional procedures via angiography; e.g. embolisation, thrombolysis. Plain abdominal radiographs: One lecture given by Dr. kawa Abdulla
  9. 9. Objectives: Proper analysis of plain films Illustration of causes of abnormal plain films Syllabus: -The basic plain abdominal radiographs. -illustration of normal & abnormal plain films -analysis of GIT dilatation -analysis of extraluminal air. -analysis of GIT opacities & calcification on plain films -analysis of hepatic & splenic abnormalities on plain films -analysis of ascites; abdomino-pelvic masses on plain films GIT Contrast examination &other imaging modalities: Five Lectures by Dr. kawa Objectives: Analysis of role & findings of contrast studies & different imaging modalities in the GIT including US; CT; MRI; isotope studies& angiography Syllabus:
  10. 10. -proper technique; limitations & hazards of contrast examinations. -proper technique; limitations & hazards of other imaging modalities. -analysis of causes & findings of barium study abnormalities; including strictures; filling defects & ulcerations. -dedicated evaluation of major topics: GIT malignancies; peptic ulcer; malabsorption syndrome; ulcerative colitis & Crohns disease with diverticular disease. -emphasis on the role & findings on US; CT; MRI -emphasis on the role & findings of isotope studies& angiography especially in GI bleeding Hepato-biliary system; three Lectures given by Dr. kawa Objectives: -analysis of role & findings of US; CT; MRI; isotope studies & angiography in Hepatic; biliary; splenic & pancreatic problems -analysis of role; findings; limitation& hazards of biliary contrast examinations & isotope studies. Syllabus:
  11. 11. -normal imaging appearances of liver; spleen; pancreas & biliary system with the gall bladder. -analysis of causes & findings of liver masses; cysts & abscesses. -analysis of findings in cirrhosis & portal hypertension and in liver trauma. analysis of role; findings; limitation& hazards of ERCP; PTC – -analysis of imaging findings & limitations in cholecystitis ; GB &bile duct stones -analysis of imaging evaluation of jaundice starting with non invasive studies US, CT; MRI & MRCP with occasional isotope studies then to diagnostic& therapeutic ERCP & PTC -dedicated evaluation of causes & findings in splenomegaly -emphasis on the imaging findings in splenic trauma -analysis of imaging role & findings in pancreatic tumors and in acute & chronic pancreatitis. Peritoneal cavity & retroperitoneum; two Lectures given by Dr. kawa Objectives: -analysis of imaging role & findings in ascites; peritoneal tumors& intra- peritoneal abscesses -analysis of imaging role; findings & limitation in evaluation of the adrenal glands; abdominal aorta; para-aortic lymphadenopathy& retroperitoneal tumors and abscesses. Syllabus:
  12. 12. -analysis of imaging role & findings in ascites. -analysis of role & findings of US; CT& isotope studies in intra-peritoneal abscesses. -analysis of findings on US& CT in peritoneal tumors -US; CT & MRI appearance of normal retroperitoneal structures - US& CT evaluation of para-aortic lymphadenopathy. -imaging evaluation of adrenal adenoma-functioning conns & Cushing's and non functioning adenomas - US; CT; MRI &isotope studies evaluation of pheochromocytoma & adrenal metastases - Aortic aneurysms US; CT; MRI &angiographic evaluation. -imaging evaluation of retroperitoneal abscesses & tumors
  13. 13. Chest : Seven lectures given by Dr . Abeer Kadum Abass Objectives : 1- Role of different imaging modalities in the evaluation of different chest diseases . 2- Proper reading of normal CXR . 3- Correlation between clinical & CXR findings for accurate way of achieving diagnosis . Syllabus : - Normal CXR interpretation . - Abnormal chest radiograph ; Silhouette sign & radiological signs of lung diseases : air space filling ( pul. Odema & pul . consolidation ) , pul . collapse , spherical pul. Shadows , band like pul. Shadow , wide spread small shadows . - Pleura ; CXR findings , & causes in pleural effusion ( free & loculated ) . - Pleural thickening . - Pleural tumors . - Pneumo thorax ( diagnosis , causes & types ) . - Mediastinum ; compartment , plain chest film findings in mediastinal masses & complementary CT. Pneumo - mediastium ( causes & CXR findings ). - Hilar enlargement ; unilateral & bilateral ; causes & CXR findings . - Diaphragm : Normal anatomy , variant & causes of marked unilateral elevation of hemi diaphragm . - Specific diseases : Infection : Bacterial pneumonia , viral & mycoplasma pneumonia , lung abscess , pulmonary TB ( Primary & post primary ) , fungal & parasitic disease, pneumonia in immunocompromised host .Sarcoidosis . diffuse pulmonary fibrosis ; CXR findings & try to determining the cause of the abnormal CXR findings . - Diseases of air way passages ( Asthma , bronchiolitis , acute bronchitis , chronic obstructive air way diseases , cystic fibrosis ) ; definition , & CXR findings ) . - Respiratory distress in the new born (Meconium aspiration & hyaline membranes disease) CXR findings & complications of therapy. - ARDS; causes & CXR findings.
  14. 14. - Pulmonary embolism & infarction (CXR diagnosis, role of CT angiography & Radionuclide scanning) . - Trauma to the chest (CXR & CT ) findings . - CA Bronchus (CXR findings in peripheral & central) , spread . - Metastatic neoplasm to the chest (lung, chest wall, pleura, & mediastium) . - Lymphoma in the chest. - Mammography; indications, plain radiograph & US findings in benign & malignant focal lesions. Cardiovascular system ( CVS ) : Four lectures given by Dr . Abeer Kadum Abass . Objectives: 1- Role of imaging techniques in evaluation of cardiovascular disease. 2- Proper interpretation of the CXR; regarding normal & cardiac diseases. 3- Emphasized that CXR is useful for looking at the effects of cardiac diseases on the lung & pleural cavity , but provide only limited information about the heart itself . Syllabus: - Evaluation of the CVS , with CXR , Echo & Doppler , CT & CT angiography , MRI & MRA , Radionuclide techniques , cardiac catheterization & angiography . - Cardiac disease; size (common causes of chamber enlargement), Chamber hypertrophy & dilatation. - Valve movement deformity & calcification. - Ventricular contractility. - Pericardial diseases (effusion & calcification).
  15. 15. - Pulmonary vessels: increased flow (CXR appearance & causes), decreased flow (CXR appearance & causes). - Pulmonary arterial hypertension causes & CXR appearance. - Pulmonary venous hypertension causes & CXR appearance. - Pulmonary odema : Types , causes & CXR findings . - Specific cardiac disorders; Heart failure , valvular heart disease , LT – atrial myxoma & other intracardiac tumors . - Common Congenital heart diseases; LT –RT shunt, coractation of aorta , Tetrology of Fallot .
  16. 16. Bone & Joint diseases: Four Lectures by Dr. Salah Kalary - First: principal of reading of bone images in different modalities specially plain X-ray - Second: how student can approach focal bone lesion & steps of imaging consequences - Third: principal of differentiation between aggressive & benign bone lesions - Fourth: principal of differentiation between joint degenerative changes like OA & inflammatory joint diseases like RA Fifth: information about criteria of differentiation between most common type of polyarticular joint diseases. - Syllabus: - Imaging techniques used in Dx of bone disease( role of different imaging modalities in approaching the bone disease - Signs of bone disease in plain X-ray - Types of bone diseases; focal , generalized & alteration in the trabecular pattern or changes in the shape - Radiological approach for diagnosis of solitary bone lesions - Bone tumors, including primary (benign & malignant)& secondaries - Bone infection: Pyogenic (acute & chronic) & TB - Generalize decreased bone density (osteopenia) - Osteoporosis. - Rickets &Osteomalacia. - Hyperparathyroidism. - Multiple myeloma. - Generalized increase in bone density - 1-Paget’s disease - 2- Thalassemia - 3-Radiation induced bone diseases - Changes in bone shapes - Diaphyseal aclasia - Joints diseases ( 2 lectures each of 1 hr) - Imaging technique (roles of each modalities in Dx of joint disease) - Approach in Dx of arthritis & radiological features of deferent type of arthritis including OA, inflammatory & metabolic arthritis & principle differentiating radiological points between them - Osteochondritis including Perthe’s , Kienbock’s disease - Freiberg’s disease Kohler’s disease
  17. 17. - Slipped femoral epiphysis - Developmental dysplasia of the hips (DDH or CDH) - Internal derangement of the knee joint - Shoulder Rotator cuff tear Bone Trauma: One Lecture by Dr.Salah Kalary. Objectives: - Role of plain radiograph in bone trauma. - Signs of Fracture & dislocation. - Role of nuclear medicine, CT & MRI in bone trauma, - Stress fracture. - Insufficiency fracture. - Pathological fracture. - Salter Harris classification. - Non-accidental trauma.