450 CLINICAL RADIOLOGY

Book Reviews

Computed Tomography of the Whole Body. Edited by J. R. Haaga and R. J. Alfidi. C. V. Mosby, St Louis, 1983. 1069 pp. £100.00

With the arrival of each new CT publication from the USA the 'experience gap' between us seems to grow apace and it is difficult to recall that CT really was a British invention, unhappily seques- tered to foreign lands, whose pundits have been able to explore and exploit to the full the scope of its brilliant potential. As it is, we accept the published fruits of their work and initiative with gratitude and humility, for they supply us with works of reference of the greatest value in our day-to-day CT diagnosis.

This two-volume work was published last year, yet many of the references are as recent as the preceding year. This unusual speed of production is a tribute to publishers, editors and contributors and must have involved a rare degree of dedicated teamwork.

The two editors are well known for their many publications on computed tomography but in their quest for excellence they have called upon their colleagues to Write authoritative chapters, so that more than 50 CT experts have contributed to its 1000 pages and there are almost 2500 excellent photographic reproductions with informed and informative captions. Here and there the pressure of high-powered editing and publishing breaks through as a wrongly labelled photograph or spelling mistake, but this does not detract from the uniform authority of this impressive work.

After dealing with the imaging principles of computed tomogra- phy the first volume is dedicated to the central nervous system, sinuses, spine, mediastinum and heart. Several of the reproduced scans of the orbits and sinuses are somewhat disappointing but they illustrate their points well enough and in acceptable detail. The second volume covers the remainder of the body. The quality of most of the scans of the abdomen is extremely good and some of the chapters (those on liver, pancreas and adrenals, for example) are models of informed communication. Separate chapters are allocated to peritoneal abscesses and paediatrics and no less than 67 pages are devoted to CT-guided procedures, the latter written by the first of the two editors. It is clear that the author of this chapter is a very experienced and enthusiastic virtuoso with the CT- controlled biopsy needle and he is so immersed in the subject that his personal feelings tumble out of the pages in a torrent of verbal cut and thrust, to the detriment of cool clarity and scientific reasoning. Nevertheless, this is probably the most comprehensive account of the method available and should be read by all who practise this investigation.

The last 30 pages are grouped under the heading 'Current Technology including NMR'. There are brief sections on CT of multiple sclerosis, stereotactic guidance systems, thin-section CT of the larynx, parathyroid localisation, acute renal inflammatory disease and the petrous bone. The final 30 pages introduce the reader to the principles of NMR imaging, with a brief assessment of its clinical potential. Although interesting and informative, and in line with the ambitious nature of the book, it feels somewhat out of place and sits uneasily in a work wholly dedicated to computed tomography.

Most CT imaging radiologists seek a reference book which illustrates clearly the largest possible number and variety of clinical problems which might require investigation by CT. The photographs and their captions are all-important, a good text being an added bonus but, often, not the prime .requirement. There are now at least three major works on CT available from the USA and all are excellent. The present publication scores heavily in the number of cases illustrated, the experience and authority of its many contributors and the comprehensive treatment of the subject as a whole. Not surprisingly, it is by no means perfect: for example, the quality of the thoracic scans does not equal that of those illustrated in Moss, Gamsu and Genant's book, where comparative studies are made, the annotation is better and the subject is treated with greater depth and appreciation; but the central nervous system is excluded from their book so that comparison is not strictly possible.

If a choice has to be made between the three works and if total coverage is the requirement, these books, by Haaga and Alfldi, have more to offer the experienced CT imaging radiologist than the others, although the choice is very much a personal one and ! would set aside the others with considerable regret. Inevitably, the price is high, but the value is there if the money is available.

Basil Strickland

Illustrated Computer Tomography. Edited by S. Takahashi. Springer-Verlag, Berlin, 1983. 306 pp., 313 figs. $85.40.

This book on CT by multiple authors from Japan covers many aspects of the subject in a most informative manner. Part 1 deals with the basic aspects of computed tomography, describing the principles of the technique, the CT scanner, performance evalua- tion, the actual procedure and its interpretation and exposure dosage. Some of the chapters in this part of the book are highly technical but they describe, with useful diagrams, many of the principles of the physics and computing of this form of radiological imaging.

The second part comprises an atlas of computed tomography in the normal adult. About 120 CT scans, accompanied by approx- imately 70 line drawings, demonstrate the normal cross-sectional anatomy of an adult patient. This is an extremely valuable part of the book. Anyone learning CT interpretation will need to be familiar with these normal appearances.

Part 3 discusses and describes the clinical applications of CT. First, the general principles of the appearances of images of lesions and then each part of the body in turn. This is, perhaps, the weakest part of the book, for only a thumbnail sketch of abnormalities demonstrated by CT can be given, though the illustrative cases do demonstrate the possible uses of CT and many useful references to more complete works are given.

'Radiotherapy Planning and CT' is the title of Part 4, which provides a good guide to how CT can aid in radiotherapy. The illustrations and figures throughout the book are of very high quality and almost 500 references are given.

This is an extremely good and not too lengthy book on CT, of great help to someone starting this subject, both for the basic principles and for a guide of the uses of CT. The prose suffers in many places from being somewhat rigid and the English of some of the contributors is often clipped. This does not make for easy reading. Nevertheless, the book is strongly recommended to all those radiologists and physicians who need to have a basic know- ledge of CT and its applications. This is also a useful book for references and might well be given a place on the shelves of departmental libraries. I .H. Kerr

Atlas of Sectional Anatomy: Head, Neck and Trunk. By P. McGrath and P. Mills. Karger, Basel, 1984. 240 pp., 105 figs. $49.25.

With the many developments in diagnostic imaging in recent years the Radiologist needs to have a more detailed knowledge of sectional anatomy. This book is based on material used in courses in sectional anatomy conducted in the Department of Anatomy at the University of Sydney.

The text covers gross anatomy of cadavers from the head to the pelvis in both the male and the female. Sections of the head are illustrated in axial, sagittal and coronal series. The thorax, abdomen and pelvis are illustrated in axial and sagittal planes. An orientation diagram of each particular section is provided on the facing page to facilitate the reader in relating the sections to the skin surface and skeletal frame of the patient. Very useful anatomical notes accom- pany each labelled cadaveric section, also on the facing page. It is very convenient to have descriptive anatomy and photographs readily accessible without turning pages. An important inclusion in the notes is the relationships of vascular anatomy.

There is a lack of any colour illustration in the text which leads to a very slight, but not significant, difficulty in analysing some of the more complicated sections. However, this atlas is very reasonably priced and, of course, the addition of colour would add considerable expense. The actual size of the atlas is over one foot square which makes the book slightly cumbersome.

There is no doubt that this atlas is a very valuable anatomy reference for the radiologist involved in computed tomography, magnetic resonance imaging or ultrasound. The orientation of right and left on the axial slices is similar to that in CT. Since we can now image in sagittal and coronal planes in CT, NMR imaging and ultrasound, this book provides the necessary anatomy in these different planes. Certainly, the authors have put considerable effort into the preparation of this sectional anatomy atlas. It is an ideal text for the radiologist involved in modern diagnostic imaging.

James F. Griffin