460 CLINICAL RADIOLOGY

Book Reviews

Atlas of Human Cross-sectional Anatomy. By D. R. Cahill and M. J. Orland. Lea & Febiger, Philadelphia, 1984. 139 pp., 119 figs. $32.50.

This book sets out to illustrate photographs of sections prepared from the head, neck, chest, abdomen and pelvis of frozen cadavers. Each section has been photographed from above and below. Thus, half the images are displayed as if viewed from below (as in body CT), while the adjacent images are displayed as from above. By having both images on the same page the reader has to exercise considerable mental agility when attempting to follow a particular structure from one cut to the next. On each page there is a small thumbnail sketch of a skeleton showing the level of the cross sections displayed.

The photographs themselves are clear and, by design, only sparsely labelled. The accompanying line drawings are larger and comprehensively labelled. On occasions, the black labelling line is hard to distinguish from the black-and-white line drawing. No doubt colour would have helped to clarify certain structures but this would inevitably have pushed the price well above what the pocket would stand.

Anatomical variations in the cadavers illustrated are, fortunately, few. However, the normal gall-bladder does not often abut the inferior vena cava in quite the fashion shown here. Nor is the full extent of the splenic, portal and right branch of the portal vein often seen on a single axial section.

This book has been written by an anatomist and a clinician and is dedicated to 'colleagues and students of anatomy, medicine and surgery'. It is less clear where the radiologist comes into all this. Certainly, every radiologist now needs to have a detailed knowledge of cross-sectional anatomy. However, I consider that the left-right confusion limits the usefulness of this book as a ready reference for the CT radiologist. Furthermore, the emphasis is not really centred on those problems where a radiologist most needs to refer to an anatomical text. To quote examples: the bronchopulmonary seg- ments are not detailed; the divide between the right and left lobes of the liver is not made clear; the limbs are not included. However, the neck is beautifully illustrated - a boon to those who, like me, find this region difficult! With regret I must conclude that there are better cross-sectional anatomy books now available for CT workers, although few so competitively priced.

Adrian Dixon

Whole Body Computerized Tomography. By O. H. Wegener. S. Karger, Basel, 1983. 396 pp., 214 figs. $49.25.

Computed tomography is rapidly catching up with the more established branches of diagnostic radiology in acquiring a range of textbooks, varying from the pocket handbook to the large (and expensive) definitive tome. Dr Wegener 's book falls in the centre of this range as he combines his experience with CT since 1976 with the accumulated world literature. The result, as stated in the foreword, is intended as 'an introduction to whole body CT and as an aid to radiologists already working with scanners'.

The German edition was first published in 1981 and so this English translation is, in theory, already 2 years out of date. However, this is hardly noticeable and perhaps not crucial in an introductory text. The translation is generally good with only occasional clumsy words, for example, 'caudalward'. However, I found the expression 'regional lymphomas' in a context meaning regional lymph nodes confusing at first glance.

The book is divided into 10 chapters. The first few act as a general introduction, simply outlining the mathematical principles involved and introducing concepts such as partial volume effect. As expected from a publication sponsored by a pharmaceutical company, there is much on the use of contrast media, with elegant diagrams explaining

differing contrast bolus regimes. There follow five chapters covering the cranium and neck (excluding intracranial CT), thorax, abdomen and peritoneal space, urogenital tract and retroperitoneal space and, finally, a chapter on the skeleton and soft tissues.

The text is informative and concise, with appropriate emphasis on the more common uses of CT, for example, assessment of mediastinal tumours. The chapters are divided into various sections to cover the different major organs. Each section starts with a short anatomical review and a brief account of a suitable examination technique. The CT appearances in various diseases are then described together with numerous accompanying high quality illustrations. A short glossary on CT terminology is useful; so is the extensive list of references (762 in all).

The most outstanding feature is the excellence of the anatomical line drawings which correlate with CT images on the opposite page. There are numerous other superb anatomical drawings of areas which are the most difficult to comprehend in cross-section; for example, the female pelvis, the right hypochondrium and the pathways of bronchi pulmonary arteries and veins. These drawings are clearly labelled, although I was disappointed to find Latin names used for most structures (do you know what the vesica fcllea is?).

This book successfully achieves its aim of providing an introduction and guide to CT. It would seem admirably suited to departments in district general hospitals with access to CT images, as well as being useful in established scanning units. It should certainly be available in training departments for the benefit of FRCR candidates.

Martin Rimmer

The Clinician's Guide to Diagnostic Imaging. By Zachary A. Grossman, David A. Ellis" and Stephen C. Brigham. Raven Press, New York, 1983. 274 pp. $17.50.

This is a refreshing book on diagnostic imaging for it contains no scans or radiographs; in fact, the authors are not concerned with interpretation but have chosen 42 clinical problems and demonstrated the best use of diagnostic imaging tests to find a solution. Topics chosen are conveniently grouped into systems. The rationale underlying each investigation is given with the authors' reason for its use at that point in the work-up. The suggested steps are then summarized and, fina!ly , additional comments are made on aspects such as inherent limitations of techniques or an explanation of why a 'popular ' test should no longer be used.

The protocols naturally reflect the level of equipment in American radiology departments, for instance, moving directly from ultrasound to CT in evaluating biliary tract obstruction, but alternative approaches for use in the absence of high technology are suggested. It would be surprising if the choice of problems met with universal acceptance: neurologists might like to have found epilepsy, transient ischaemic attacks or visual loss included but, on the whole, the subjects chosen do generate logical schemes which can easily be adapted to related problems.

The text is clearly and concisely written, well set out and well indexed. It is surprising to find a chapter on 'Promising New' techniques (PET, NMR, SPECT). Considering the nature of the book it seems premature, as their precise role has yet to be determined. The inclusion of a glossary is a good innovation; not only clinicians will find it helpful! Patient preparation is covered in an appendix designed to promote awareness and understanding of the need for such action, rather than be comprehensive.

The complexity and number of available diagnostic imaging tests has generated a need for such a book which is aimed at clinicians and will be of value to them. Radiologists in training, medical students and technicians will also profit from this approach, which should do much to encourage communication, the essence of good radiological practice.

M. I. Lavelle