PředmětyPředměty(verze: 837)
Předmět, akademický rok 2018/2019
   Přihlásit přes CAS
Radiologie a nukleární medicína - EA0108035
Anglický název: Radiology and Nuclear Medicine
Zajišťuje: Klinika zobrazovacích metod (14-440)
Fakulta: Lékařská fakulta v Plzni
Platnost: od 2011
Semestr: zimní
Body: 3
E-Kredity: 3
Způsob provedení zkoušky: zimní s.:
letní s.:
Rozsah, examinace: zimní s.:1/1 Z [hodiny/semestr]
letní s.:1/1 Z+Zk [hodiny/semestr]
Rozsah za akademický rok: 15 [hodiny]
Počet míst: zimní:neomezen / neomezen (neurčen)
letní:neomezen / neomezen (neurčen)
Minimální obsazenost: neomezen
Stav předmětu: vyučován
Jazyk výuky: angličtina
Způsob výuky: prezenční
Úroveň:  
Poznámka: odhlásit z termínu zkoušky při nesplněné rekvizitě
Garant: prof. MUDr. Boris Kreuzberg, CSc.
Vyučující: doc. MUDr. Jan Baxa, Ph.D.
prof. MUDr. Jiří Ferda, Ph.D.
prof. MUDr. Boris Kreuzberg, CSc.
doc. MUDr. Hynek Mírka, Ph.D.
MUDr. Petra Mrázková, Ph.D.
MUDr. Jan Záhlava
Kategorizace předmětu: Lékařství > Klinické předměty
Korekvizity : EA0106013, EA0106014
Je korekvizitou pro: EA0110019, EA0110024, EA0110026, EA0110116, EA0110030, EA0110057, EA0110023, EA0110029
Anotace -
Poslední úprava: BURIANKO (25.07.2003)
Základy konvenční rentgenové techniky a radiační hygieny - RTG kontrastní látky - Moderní radiodiagnostické vyšetřovací metody (VT, USG, DSA) - Radiodiagnostika ledvin a močových cest - Radiodiagnostika jater, sleziny a pankreatu - Radiodiagnostika srdce a velkých cév - Neuroradiologie mozku - Neuroradiologie míchy - Radiodiagnostika onemocnění plic, pleury a mediastina - Radiodiagnostika nadledvin - Radiodiagnostika prsu - Radiodiagnostika v porodnických a gynekologických indikacích - Radiodiagnostika žlučových cest
Literatura
Poslední úprava: BURIANKO (30.07.2003)

Blažek a spol. : Radiologie a nukleární medicina. Praha Avicenum 1989

Chudáček Z.: Radiodiagnostika pro mediky. Praha SPN 1986

Nekula J., Heřman V., Köcher M.: Radiologie. UP 2001

Požadavky ke zkoušce - angličtina
Poslední úprava: Lenka Kasalová (24.05.2018)

 

The requests for studying -at practical exercises  good knowledge of actual problematic (according to the sylabus)

 

The student could obtain the winter and summer semester credits under the condition of sufficient  attendance at practical excersises (one absence in the semester possible) and having successful result from the test.The test contains the items from the lectures and practical exercises from relevant semester

 

The exam-both credits necessary.

 

Sylabus
Poslední úprava: Lenka Kasalová (24.05.2018)

Course: Radiology and Nuclear Medicine

Extent of teaching: 15 hours lectures, 15 hours exercises

Semester: 7 and 8 semester, 4 year

Number of credits: 4

Form of teaching: lectures, exercises

Name of workplace: Clinic of Imaging Methods

Completion: Credit, examination

 

Abstract:

 

Radiodiagnostics

 

Field history - W. C. Roentgen, the discovery of X-rays, classical period of radiology (1895 - 30th years of the 20th century), the invasive radiology (40th years - 70th years), the non-invasive radiology (70th years - present), current division into the non-invasive imaging and interventional radiology.

Basics of X-ray examination - the principle of X-ray tube, production of X-rays, the interaction of matter and X-rays, X-ray machine and its parts. Principles of radiography and fluoroscopy. Elektronoptical amplifier. Conventional tomography. Contrast of X-ray image. Geometrical resolution. Geometrical and motion blur image. X-ray contrast media - negative and positive. Barium contrast media. Iodinated contrast media - oil, water-soluble ionic ano non-ionic contrast agents. Adverse reactions to iodine contrast substances and their management.

Modern imaging methods - computed tomography (CT) - basic principles and indications, principles of CT image formation, pixel and voxel, density measurement, Hounsfield units, generation of CT, spiral CT and its new software applications (3D image reconstruction, CT angiography, perfusion CT), multidetector CT. Contrast agents for CT and their use. Ultrasonography (USG) - the principle of an ultrasonic signal production and detection. A, M and B mode, real-time image display. Doppler ultrasound basics - color Doppler, spectral Doppler. Contrast enhanced ultrasonography. Digital subtraction angiography (DSA) - principles of image digitalisation, the suppression of unwanted structures. Seldinger´s catheterization technique. Magnetic resonance (MR) - basic principles, precession, Larmor frequency, relaxation times T1 and T2, examination sequences - spin echo, T1 and T2 weighted images, proton density, suppression of signal of fat and water. The use of paramagnetic contrast agent. Advantages of MRI over CT, main indications. MR angiography (native and contrast).

Lungs, pleura and mediastinum - General Part - basics of imaging anatomy. Basic examination methodsl (X-ray, CT, ultrasound, DSA, methods of biopsy). Special part - congenital defects (agenesis of the lung, lung cysts), bronchial diseases (chronic bronchitis, bronchiectasis, asthma), pulmonary emphysema. Atelectasis. Pneumothorax (spontaneous and traumatic). Inflammation of the lungs - the basic division - croupous (lobar pneumonia), bronchopneumonia (lobular pneumonia), interstitial pulmonary inflammation. Lung abscess. Pneumoconiosis (lung silicosis). Pulmonary sarcoidosis. Pulmonary fibrosis. Embolization to the pulmonary artery. Primary lung tumors - benign and malignant semimaligní. Primary bronchogenic carcinoma - basic forms-the central and peripheral. Special forms - Pancoast´s tumor and cancer in the scar. Decay process for lung cancer (Jorres´s cavern). Secondary lung tumors - metastasis. Pleuritis exsudativa, free pleural effusion in the cavity, different types of encapsulated pleural effusion (wall and interlobar, diaphragmatic). Etiology of effusion - postinfectious (Empyema), post-traumatic (hemothorax), metastatic, the left heart failure. Pleuritis adhesiva, pleuritis calcarea. Primary tumors of the pleura - mesothelioma, relation to asbestosis. Mediastinal non-tumorous affections, hematoma, mediastinitis. Tumors of the anterior mediastinum (thymom, retrosternal goiter), middle mediastinum (cysts, lymph nodes infiltration), posterior mediastinum (neurogenic tumors), mediastinal teratoma.

Heart and vascular system - General Part - imaging anatomy of the heart, heart examination methods - non-invasive (X-ray, echocardiography, CT and MRI), invasive - angiocardiography, coronarography. Special part - congenital and acquired heart diseases. Myocardial disease, ischaemic heart disease, coronary sclerosis, diseases of the pericardium, heart tumors, signs of right-and left-sided heart failure. Signs of atherosclerosis, Burger´s disease, arterial aneurysms, dissection, AV malformation, deep venous thrombosis, venous insufficiency, postphlebitic syndrome.

Lymphatic system - General Part - examination methods - USG, CT, lymphography. Special part - lymphedema, lymphoma, metastatic involvement of the lymph nodes.

Kidneys, urinary tract, prostate - General Part - basic examination methods - plain film, intravenous urography, USG, CT, MRI, DSA, ascending pyelography, cystography, voiding cystourethrography. Imaging anatomy. Special part - congenital kidney and urinary tract disorders (polycystic disease and vesicoureteral reflux) nefrolithiasis and its complications, hydronephrosis, pyonephrosis. Ren migrans, dystopic kidney. Inflammatory kidney diseases - acute and chronic pyelonephritis, renal abscess, paranephric abscess, tuberculosis, kidney. The question of investigation of renal impairment. Kidney tumors - benign and malignant, conventional renal cell carcinoma, Wilms' tumor. Renovascular hypertension - the methods of investigations, renal artery stenosis atherosklerotická, fibromuscular dysplasia renal artery, other causes of renovascular hypertension. Radiodiagnostics of  kidney graft - signs of acute and chronic rejection. Pathological changes in the urinary bladder - congenital diseases, bladder diverticula. Inflammatory disease - acute and chronic cystitis. Tumors of the urinary bladder - papilloma, papilokarcinoma. Cystolithiasis. Investigation of the prostate - ultrasonography ( transabdominal, endorectal), magnetic resonance imaging. Benign prostatic hyperplasia, prostate cancer.

Gynecology and obstetrics. General Part - examination methods - plain X-ray, hysterosalpingography (HSG), ultrasound (transabdominal, endovaginal), CT, MRI. Special part - congenital diseases of the uterus, changes in primary and secondary sterility, inflammation of the uterus and adnexa, uterine and ovarian tumors (increasing role of CT and MRI). Ultrasonic investigations in pregnancy - detection of pregnancy, normal finding in various stages of pregnancy, fetal biometry, pregnancy pathology in the first trimester (silent miscarriage, molla hydatidosa, ectopic pregnancy). Pregnancy pathology in the 2nd and 3 trimester (diagnosis of congenital defects, oligohydramnios and polyhydramnios, placenta praevia, placental abruption, fetal death). Multiple pregnancy. Determining the sex of the fetus. Amniocentesis.

Liver, spleen and pancreas. Liver - General Part - examination methods - X-ray, ultrasound, CT, MRI angiography. Imaging anatomy. Special part - focal liver lesions - liver cysts (simple, parasitic, cystic tumors), liver abscess. Benign liver tumors (hemangioma and its differentiation from malignant tumors (dynamic CT), focal nodular hyperplasia, hepatocellular adenoma). Hepatocellular carcinoma. Liver Injury. Diffuse liver diseases - steatosis, hemochromatosis, liver cirrhosis, complications of cirrhosis (portal hypertension, ascites, esophageal varices). Hepatocellular carcinoma in cirrhosis. Spleen - General Part - examination methods, imaging anatomy. Special part - focal lesions. Splenomegaly (active and passive). Injuries to the spleen. Pancreas - General Part - examination methods - X-ray (calcifications), ultrasound, CT, MRI, DSA, ERCP. Special part - congenital diseases (especially pancreatic cystic fibrosis). Acute Pancreatitis. Forms of inflammation. Complications including pseudocyst formation. Chronic Pancreatitis, hypertrophic and atrophic form, the differential diagnosis versus tumor. Pancreatic tumors - pancreatic cancer, pancreatic endocrine active tumors (insulinoma, gastrinoma, etc.). Injuries to the pancreas.

Biliary tract. General Part - examination methods - X-ray, ultrasonography, CT, MRI (including MRCP), ERCP, percutaneous transluminal cholangiography (PTC), intraoperative and postoperative cholangiography ( cholangiography to T-drain). Imaging anatomy. Special part - congenital biliary tract diseases - bile duct cyst, biliary atresia, m. Carroli. Cholecystolithiasis - symptoms and complications. Differential diagnosis of obstructive jaundice. Inflammatory processes of the biliary tract - acute and chronic cholecystitis, cholangitis. Biliodigestive fistula, biliary ileus. Aerobilia. Tumors of bile ducts and gallbladder.

Gastrointestinal tract. General Part - examination methods - x-ray and its indications - ileus (mechanical and paralytic), pneumoperitoneum, foreign bodies. Contrast examination of the GIT and its contraindications. Requirements for quality of barium sulfate for gastrointestinal examinations. Single- and double-contrast examination. Imaging methods of the esophagus, stomach, small intestine and colon - X-ray, USG, CT, MRI, DSA. Special section - Esophagus - imaging anatomy. Esophageal diverticula, kardiospasmus, inflammatory processes (gastroesophageal reflux and corrosive oesophagitis, candidiasis). Tumors of the esophagus - benign (leiomyoma) and malignant (carcinoma), complications (tracheobronchial fistulas). Postoperative changes. Stomach - imaging anatomy. Diverticulosis, inflammatory processes (gastritis). Gastroduodenal ulcer. Direct and indirect signs of ulcer. Complications of peptic ulcer disease (perforation, penetration, bleeding, pyloric stenosis, malignant degeneration of ulcer). Tumors - benign (polyps) gastric cancer - macroscopic form (polypoid, ulcer scirhotic). Post-operative conditions of the stomach (after resection Bilroth type I and II, total gastrectomy). Small intestine - imaging anatomy. Diverticula of the small intestine. Disorders of rotation and fixation of the small intestine. Malabsorption syndrome. Chronic inflammation of the small intestine (Crohn's disease). Tumor processes of the small intestine. Colon - imaging anatomy. Disorders of bowel rotation and fixation. Megacolon congenitum (Hirschprung´s disease). Intususception. Colonic diverticulosis and diverticulitis and its complications. Chronic inflammation of the bowel - Crohn's disease and ulcerative colitis. Tumors - benign (polyps and polyposis syndromes) and malignant colorectal cancer - differences in right and left colon. Conditions after surgery colon. Disorders of bowel emptying (defecography).

Adrenal glands and retroperitoneum. Adrenal glands - general Part - exaination methods (X-ray, USG, CT, MRI, angiography - arteriography, phlebography with suprarenal venous blood sampling). Imaging anatomy. Special part - adrenal atrophy (m. Addison), hyperplasia and adrenal tumors - hyperfunctional syndromes of adrenal cortical tumors (adenomy, carcinoma) - Conn's syndrome, Cushing´s syndrome, adrenogenital syndrome. Tumors of the adrenal medulla (pheochromocytoma). Adrenal tumors in childhood (neuroblastoma). Retroperitonuml - imaging anatomy. Retroperitoneal fibrosis (Ormond´s disease). Tumors (nodal and others).

Breast - General Part - examination methods - mammography, USG, MRI, biopsy methods (aspiration cytology, true-cut biopsy, vacuum biopsy. Special part - fibrous-cystic mastopathy, fibroadenoma, carcinoma. Screening for breast cancer. Investigations of postoperative breast condition (after resection, mastectomy, breast augmentation)

Neuroradiology. Brain. General Part - examination methods. Skull X-ray (basic and special projections), CT (native and postcontrast), MRI, angiography, USG (in infancy). Special part - congenital defects of the brain - hydrocephalus, corpus callosum aplasia. Vascular diseases - atherosclerosis, cerebral infarction, cerebral hemorrhage, cerebral aneurysms - subarachnoid hemorrhage. Arteriovenous malformation. Venous thrombosis. Arteriovenous fistula (carotidocavernous fistula). Inflammatory diseases of the brain - brain abscess, infectious inflammatory disease of gray and white matter - encephalitis. Inflammatory diseases of the meninges, meningitis. Degenerative brain diseases - cerebral atrophy, Alzheimer's disease, demyelinisation diseases - multiple sclerosis. Injuries to the brain - cerebral edema, contusion, intracerebral hemorrhage, epidural, subdural and traumatic subarachonideal hematoma. Brain Cancer - Symptomatology of brain tumors in various diagnostic modalities. Primary brain tumors - brain glioma grade I-IV. Meningioma in various locations. Childhood brain tumors - the cerebellum medulloblastoma. Secondary brain tumors - metastasis. Spinal cord and spine. General Part - examination methods - X-ray, CT, MRI, DSA, perimyelography (PMG). Imaging anatomy. Special part - congenital defects, syringomyelia. Meningomyelocele. Injuries (types of fractures of vertebral bodies - stable and unstable fractures). Diseases of the intervertebral disc - disc herniation, inflammation of the intervertebral disc (spondylodiscitis). Tumors of the spine - intramedullary, extramedullary, intradural, extradurál, primary and secondary.

Head and neck. Paranasal sinuses. General Part - examination methods - X-ray (Water´s projection), CT, MRI. Imaging anatomy. Special part - acute and chronic sinusitis and its complications. Mucocele. Tumors of the sinuses - osteoma, cysts and polyps, cancer. Injuries sinus (Le Fort I-III). Temporal bone. General Part - examination methods - X-ray (incl. special projections according to Schuller and Stenvers). CT (including HRCT), DSA, MRI. Imaging anatomy. Special part - congenital defects of the outer ear channel, middle ear and inner ear. Inflammatory processes of the middle ear - acute and chronic otitis. Their complications (abscesses, cholesteatoma). Possible intracranial promotion. Tumors of VIII. cerebral nerve (acoustic neuroma). Injuries to pyramid.

Orbit. General Part - examination methods - X-ray, USG, CT, MRI, DSA. Special part - foreign bodies. Pathological changes in hyperthyroidism. Tumor processes of the eye and orbit. Injuries.

Osteoradiology - General Part - examination methods - X-ray, CT, MRI, DSA, arthrography.

Essential terms in osteoradiology. Macrostructure of bone in X-ray image. The basic pathological changes of the skeleton. Special part - congenital defects of the skeleton - the most important congenital defects (achondroplasia, multiple cartilaginous exostoses, fibrous dysplasia, osteogenesis imperfecta, hip dysplasia). Inflammatory bone diseases - non-specific suppurative bone and joint processes. Acute hematogenous osteomyelitis primary and secondary. Chronic osteomyelitis and its special forms. Tuberculosis of bones and joints (especially specific spondylitis). Chronic aseptic joint inflammation - rheumatoid arthritis, chronic primary polyarthritis, spondylartritis ankylopoetica (m Bechtěrev). Metabolic osteopathies - presenile and senile osteoporosis (postmenopausal), bone densitometry (ultrasound, X-ray, CT). Osteomalacia. Rickets. Endocrine osteopathies - particularly changes in hypothyroidism and primary hyperparathyroidism (ostitis fibrosa cystica generalis) - diagnosis of parathyroid gland enlargement (USG, CT, MRI). Osteoporosis in Cushing´s disease. Bone changes in chronic renal insufficiency - secondary and terciary hyperparathyroidism.

Toxic osteopathies - changes in poisoning by heavy metals (lead) poisoning in non-metals (fluorine). Hypervitaminosis D. Endogenous intoxication - osteopathia hypertrophica toxicans. Circulatory disorders of the skeleton - bone infarcts, decompression disease. juvenile aseptic necrosis (Perthes´s disease and other osteonecrosis), their consequences. Injuries to the skeleton - essential terms - types of fractures and dislocations, luxation. Some specific types of fractures (subperiosteal fractures, stress fractures, epiphyseolysis, pathological fractures). Complications of fractures - skeletal growth disorders, aseptic necrosis. Healing of bone fractures - callus. Bone tumors - basic types of primary tumors and their complex symptomatology - osteogenic tumors (osteoma, osteoid osteoma, osteoblastoma, osteogenic sarcoma), cartilaginous tumors (chondroma, osteochondroma, chondrosarcoma), connective tissue tumors (fibrosarcoma), giant-cell tumor (osteoklastoma), bone marrow tumors (Ewing's sarcoma - PNET, hematologic malignancies), blood and lymph vessels tumors (hemangiomas, lymfangiomy), neurogenic tumors (schwannoma). Tumors of the joint (synovial chondroma). Special tumors - chordoma, histiocytosis X and its three forms - especially eosinophilic granuloma. Secondary bone tumors, osteolytic, osteoplastic and mixed metastases. Paget´s disease and its forms.

Basics of interventional radiology - definition and some historical notes. The main areas of intervention radiology. Vascular interventions and their indications - angioplasty - balloon dilation, stent. Therapeutic embolization, thrombolysis. Cava filters. Stentgrafts. Neurointerventions - embolisation of brain aneurysms and AV malformations. Interventions in the kidney and urinary tract - percutaneous nephrostomy, drainage of cysts and abscesses. Interventions in the biliary tract - internal and external biliary drainage, biliary stenting. Interventions in the liver and pancreas, drainage of abscesses and cysts, radiofrequency ablation, chemoembolisation, biopsy. Interventions in the heart and coronary arteries - coronary artery angioplasty, puncture of the pericardium (in exudative pericarditis). Interventions in gynecology - dilation of narrowed fallopian tubes (in sterility).

 

Nuclear Medicine

 

General concepts in nuclear medicine (NM) - the concept of field. Examination of in vivo - basic principles, indications, design, static tests, dynamic SPECT, PET. Examination in vitro - the basic principles of methods radiosaturationční analysis indication of the most common tests. Treatment with open emitters - the basic principle, the most common indications, necessary prerequisites.

Radiopharmaceuticals (RF) - radionuclides used for diagnostics ant therapy, their physical characteristics. Biodistribution and pharmacokinetic properties of most commonly used groups of RF. Preparation of RF. Radionuclide sources: nuclear reactors, particle accelerators, generator systems. Quality Control of RF.

Physical phenomena used in NM - physical properties of radionuclides - structure of atomic nuclei, radioactivity. Alpha, beta, gamma radiation - origin, properties and use in nuclear medicine. Interaction of radiation with matter.

Detection of ionizing radiation in NM - scintillation detectors: scintillator, photomultiplier - basic properties, principles of operation. Overview NM devices using scintillation detectors: two-channel scintigraph, motion scintigraph, scintillation camera - construction, basic types of collimators, analog and digital image. Detectors with gas filling: ionization chamber, Geiger-Müller detector - the basic principle of operation, equipment usage in NM. Film detectors, thermoluminescent, semiconductor.

SPECT and PET - basic principles of tomographical imaging. SPECT - the principle of a single-photon emission tomography, acquisition and reconstruction of tomographic images, advantages and pitfalls of the method. Construction of SPECT gamma cameras. The clinical use of SPECT. SPECT/CT. PET - the principle of positron emission tomography, basic components of the PET camera, other options of capture positron emitters (SPECT dual-detector camera with ultraheavy collimators, coincidence). Radiopharmaceuticals used for PET scans, clinical use. PET/CT.

Biological effects of radiation - mechanism of efect of ionizing radiation, deterministic and stochastic effects. Quantities of ionizing radiation, dosimetry and radiation protection: absorbed dose, dose equivalent, effective dose - definitions, units. Dose limits for workers with ionizing, options of protection against the radiation. Medical iradiation, principles of minimizing radiation doses in NM. Monitoring programs and quality assurance.

Radioimmunoassay - basic concepts and principles of imunoanalytic methods. Examination procedure. Indications and interpretation of the most frequently used tests: thyroid diagnostics, gynecology and prenatal diagnosis, diagnosis of growth disorders, diabetes diagnosis, tumor markers, monitoring of therapeutic doses of medication, bone metabolism, haematological diagnostics.

Examination of perfusion and myocardial viability, detection of myocardial infarction - the principle of methods used for myocardial perfusion evaluation, radiopharmaceuticals, their advantages and disadvantages. Preparing the patient, load options in stress examination, indications for examination. Planar scintigraphy of the myocardium, myocardial SPECT - differences in design and evaluation. Gated tomographic myocardial scintigraphy. Interpretation of results. Evaluation of myocardial viability - the principle, PET, alternative procedures. Scintigraphic detection of acute myocardial infarction - the principle of the method, radiopharmaceuticals.

Radionuclide diagnosis of central and peripheral circulation - radionuclide cardiography (first pass method): the principle of methods, radiopharmaceuticals, instrumentation, methodology for acquiring and evaluating data, basic analysis of flow curves, interpretation of results. Indication: Diagnosis of developmental defects, intracardiac shunts quantification, assessment of ventricular performance. Gated equilibrium radionuclide ventriculography - the principle, radiopharmaceuticals, instrumentation, data acquisition. Evaluation of ejection fraction and regional motility. Indication, position of the method in the context of other diagnostic modalities. Stress radionuclide ventriculography - diagnostic significance. Radionuclide venography of the lower and upper extremities: the principle of the method, radiopharmaceuticals, examination procedure, indications for examination, basic findings.

Radionuclide diagnosis of lung - lung perfusion scintigraphy: the principle of the method, radiopharmaceuticals, instrumentation, method of application, projections, evaluation findings. Indications for examination, most common differential diagnostic problems using a combination of ventilation-perfusion scintigraphy to improve diagnostic reliability. Ventilation lung scintigraphy: radioactive aerosols, radioactive gases, instrumentation, methods of testing with the use of gases and aerosols, interpretation of results, indications. Alveolocapillary clearance measurement: principle, radiopharmaceuticals, evaluation results, indications. Measurement of mucociliary clearance: principle, radiopharmaceuticals, indication.

Central nervous system (CNS) - static brain scintigraphy, dynamic radionuclide angiography: the principle of the methods, radiopharmaceuticals, examination procedure, evaluation findings, indications. Brain SPECT perfusion scintigraphy: the principle of imaging, radiopharmaceuticals, patient preparation, indications, diagnostic benefit. Scintigraphic examination of neuroreceptors using SPECT -  principle and radiopharmaceuticals. PET - the current status in routine clinical diagnosis and research in physiology and pathophysiology of the CNS. Radionuclide cisternography: fundamentals of cerebrospinal fluid physiology, radiopharmaceuticals, applications, examination procedure for differential diagnosis of suspected hydrocephalus and liquorrhoea. Interpretation of results. Examination of the functionality of shunts after drainage operations.

Kidneys and urinary tract - radionuclide nephrography: radiopharmaceuticals, instrumentation, output and interpretation of results, disadvantages, current position among diagnostic methods. Dynamic renal scintigraphy: the most commonly used radiopharmaceuticals, instrumentation, methodology (application of diuretics), evaluation findings, the calculation of separated renal function, simultaneous calculation of global renal function. Captopril test - principle, procedure, interpretation of results. Static renal scintigraphy: principles, radiopharmaceuticals, instrumentation, examination procedure, interpretation of results, determination of separated renal function, indications. Examination of the transplanted kidney: radionuclide cystography: direct and indirect cystography - radiopharmaceuticals, examination procedure, interpretation of results, detection of vesicourinary reflux. Evaluation of urinary residuum and miction parameters. Radionuclide methods of clearance determination: radiopharmaceuticals for the calculation of GFR and ERPF. Methods using measurements of plasma samples, using the methods of measurement in vivo.

Liver, spleen and biliary tract - static scintigraphy of liver and spleen: principle of imaging, radiopharmaceuticals, implementation, interpretation of findings, indications for examination. Comparison to other investigative methods. Scintigraphic detection of hepatic hemangiomas. Radionuclide cholescintigraphy: principle of the method, radiopharmaceuticals, instrumentation, examination procedure depending on the indication, computer processing. Clinical significance of methods for acute abdominal emergencies, abdominal injuries and a chronic biliary disorders. Spleen scintigraphy: radiopharmaceuticals, instrumentation, examination procedure, indications.

Gastroenterology - scintigraphy of the salivary glands: radiopharmaceuticals, methods, indications. Scintigraphic examination of esophageal motility: the principle of the method, radiopharmaceuticals, examination procedure, benefits of computer data processing, indications. Scintigraphic evaluation of gastric evacuation: the principle of the method, radiopharmaceuticals, methods of examination, evacuation half-time measurement, interpretation of results, indications. Determination of gastroesophageal reflux: the principle, radiopharmaceuticals, examination procedure, indications. Diagnostics of Meckel´s diverticulum: Meckel´s diverticulum pathophysiology, usual localization, examination principle, radiopharmaceuticals, examination procedure, interpretation of findings, indications. Localization of gastrointestinal bleeding: the principle of the method, radiopharmaceuticals, examination procedure, interpretation of results, indications. Examination of resorption of biologically important compounds focused on vitamin B12.

Endocrinology - thyroid scintigraphy: radiopharmaceuticals used - their advantages and disadvantages, design methodology, interpretation of results, its significance for differential diagnosis of thyroid, sonography and scintigraphy of the position of the thyroid gland in the diagnostic protocol. Measurement of accumulation of radiopharmaceutical in the thyroid gland. Scintigraphic examination of the parathyroid glands: radiopharmaceuticals, the principle of subtraction method, two-phase scintigraphy, diagnostic benefit. Scintigraphic examination of the adrenal glands: the possibility of imaging the adrenal cortex and marrow using radiopharmaceuticals.

Bones - static scintigraphy of the skeleton: the principle of examination,  radiopharmaceuticals and their properties, preparation before examination, the examination method - the benefits of whole-body scintigraphy, screening, interpretation of findings, the most common artifacts. Oncological and non-oncological indications. Side findings, specialties in childhood. Dynamic scintigraphy of the skeleton: the purpose of  three-phase bone scintigraphy, assessment of the first-pass and blood flow compartment image. Indications.

Radionuclide methods in hematology - examination of erythrocyte survival: using the properties of the chromium for labeling of erythrocytes, the principle of the test, localization of the site of destruction of erythrocytes. Determination of circulating volume and plasma erythrocytal mass: dilution principle and its use to determine the volumes of blood components, radiopharmaceuticals. Examination of thrombokinetics: problematics of platelet labeling. Bone marrow scintigraphy: radiopharmaceuticals, examination procedure, interpretation of findings. Hematological, oncological and other indications.

Radionuclide methods in oncology - general options and procedures for imaging of tumors using radiopharmaceuticals, the use of routine scintigraphic methods for cancer diagnostics (scintigraphy of the skeleton, liver, lungs, brain). Examinations using tumoraffine radiopharmeceuticals: examination with 67 Ga - methodology, indications. Imunoscintigraphic methods: currently used radiopharmaceuticals, methodology, indications. Somatostatin receptor imaging: radiopharmaceuticals, methodology, indication. Lymphoscintigraphy, sentinel lymph node detection. Mamoscintigraphy. PET and PET/CT in oncology. In vitro methods in oncology.

Detection of inflammation - basic methodological approaches, radiopharmaceuticals, labeling of leukocytes in vitro and in vivo, examinationprocedure, difficulties in interpreting the results. Indications in various types of inflammation.

Radionuclide diagnostics in childhood - specifics of the scintigraphic examination in childhood: choosing the appropriate radiopharmaceutical, problems with the use of radiopharmaceuticals, the calculation of administered activity, ensuring the patient during scanning. Methods commonly performed in childhood: kidneys, bones, liver, endocrine system, shunt detection, detection of Meckel´s diverticulum.

Therapy in nuclear medicine - general principle of therapeutic use of emitters. Treatment of benign thyroid disease: radiopharmaceutical, the success rate, possible complications, indication for therapy in the context of other treatments. Therapy of differentiated thyroid carcinoma: classification of thyroid carcinomas, the biological assumptions of successful treatment of radioactive iodine, a comprehensive approach to the patient. Amount of administered radiopharmaceutical. Radionuclide synovectomy: principle of the method, radiopharmaceuticals, the amount of administered activity, examination procedure, possible complications, indication. Therapy of polycythemia: a principle, radiopharmaceuticals. Palliative therapy in advanced cancer: therapeutic possibilities in bone metastases and malignant effusions, radiopharmaceuticals, examination procedure, possible complications. Therapy of neuroendocrine tumors.

 

Guarantor: Doc. MUDr. Boris Kreuzberg, CSc.

Clinic of imaging methods, Alej Svobody 80, Plzen

tel 377103486

E-mail: name@fnplzen.cz

Teachers:

Prof. MUDr. Boris Kreuzberg, CSc.

Literature:

According to teacher recommendations.

 

 
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