General-purpose large Vision-Language Models (VLMs) demonstrate strong capabilities in generating detailed descriptions for natural images. However, their performance in the medical domain remains suboptimal, even for relatively straightforward tasks, primarily due to the lack of large-scale, high-quality, specialized medical imaging datasets and the neglect of the diagnostic process that progresses from coarse to fine-grained. To address the first issue, we construct the CT-RATE-VQA dataset, which has 84K QA pairs. For the second issue, we propose MedReason-R1, a medical VLM with explicit reasoning process for disease diagnosis. MedReason-R1 incorporates a novel strategy that embeds zoom-in disease region-of-interest areas into the image, highlighting the crucial role of both global localization and disease-specific details in enhancing the model's diagnostic performance. Furthermore, we introduce the GRPO reinforcement learning framework to MedReason-R1, which enables effective reasoning without relying on costly manual annotations. Compared to recent general-purpose and medical VLMs, MedReason-R1 achieves state-of-the-art performance in CT disease diagnosis while retaining generalization. The code, checkpoints, and dataset are available at: https://github.com/Leevan001/MedReason-R1