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Book Reviews

CLINICAL RADIOLOGY

Chest X-ray Made Easy. By Come, Carrol, Brown and Delany. Churchill Livingston, USA, 1997. 111 pp. £9.95.

The first two sections of this book are a helpful guide on how to approach the chest radiograph in a systematic and thorough way without being mesmerized by an obvious abnormality, a common pitfall. The remaining sections deal systematically with lung, hilar, heart, mediastinum and chest wall pathologies, including a short section on the hidden abnormality. An introductory list of terms and definitions might have assisted the student to understand radiology reports and to avoid confusion when communicating with radiologists and clinicians alike. The case histories that accompany each radiograph enhance the interest and relevance of the radiographs and give the reader a better understanding of how the wide range of chest pathologies included in the text present themselves. The authors have made an excellent job of presenting the chest radiograph in a simple and concise format that should prove a firm foundation for someone starting out in clinical medicine. This little book will hopefully encourage the reader to search out more comprehensive texts without a sense of dread. We remain to be completely convinced that the chest X-ray is easy!

G. Burkill and S. Padley

Abrams Angiography, Fourth Edition, four volumes. By Stanley Baum. Little, Brown & Company, USA. 3352pp. £395.00.

This is the fourth edition of Abrams Angiography; it was first published in 1961 with second and third editions produced in 1971 and 1983 and has been the undisputed leader in its field throughout this time. It has been edited on this occasion by Stanley Baum who prefaces the new book by saying that it 'has been completely updated to reflect the dynamic change and growth of the speciality since 1983'. He has also changed the title of the book to Abrams Angiography: Vascular and Interventional Radiology and in so doing has added a third volume dedicated solely to interventional radiology which is co-edited by Dr Michael Pentecost. This third volume covers a wide range of vascular and non-vascular interventional techniques: the chapters are well-written by authors who are leaders in their particular field and have up-to-date references and the images are generally of good quality. I was surprised by the absence of a chapter on the percutaneous stenting of abdominal aortic aneurysms although stent graft insertion for thoracic aneurysms is covered. This omission presumably reflects the rapid advances that continue to be made in interventional radiology and demon- strates that any book on this subject is almost out of date as soon as it is published. Overall, however, this is an excellent volume.

The same cannot be said, however, of volumes I and II with which I was extremely disappointed. I began reviewing these two volumes by looking at the description of what is arguably the most important part of an arteriogram, the initial arterial puncture. In Chapter 41 on abdol~nal aortography, volume II, there is an excellent description of the technique of retrograde femoral artery puncture. This is largely repeated in Chapter 67 on femoral arteriography but in this section the best site for puncture is described as being ' 1-2 cm below the inguinal skin crease' ! This is such a glaring error that I can only assume that it was an editorial miss. Other puncture sites and techniques are, however, covered very poorly. There is practically no description of the techniques used to perform an antegrade femoral artery puncture and certainly no mention is made of the several methods which may be used to ensure catheterization of the superficial femoral artery as opposed to the profunda femoris when this puncture is performed. Nor is there adequate discussion of high and low brachial, axillary and popliteal artery punctures. Radial artery catheterization is not mentioned. I found many of the chapters in these two volumes hopelessly outdated. For example, the chapter on pulmonary arteriography suggested that in hnllous emphysema this procedure 'provides clinically important information by delineating with accuracy air-containing cysts or bullae and by demonstrating the displacement and crowding of adjacent vessels' and that it 'provides a means of planning resectional surgery'. As a second example, in the section on renal angiography, there are a total of 84 pages on the angiographic distinction between renal tumours and renal cysts (45 pages), the angiographic features seen in renal infection (23 pages) and those seen in hydronephrosis (14 pages). Whilst these are no doubt of historical interest, and it is indeed fascinating to see how the indications for renal angiography have changed over the years, I do not feel that such lengthy chapters can be justified in a book which should be reflecting current angiographic practise. Many of the chapters do not contain updated references: this might not, at first sight, come as too much of a surprise if one remembers that little has been written on diagnostic as opposed to therapeutic angiography over the past few years. Such an excuse cannot be used, however, when much more recent relevant literature is present. For example, a reference from 1976 is given to support the fact that survival from Wilms tumour is 50% even with widespread metastatic disease: and

© 1997 The Royal College of Radiologists, Clinical Radiology, 52, 803-805.

the references from the section on pulmonary arteriovenous malformations (PAVMs) in Volume I are all from before 1980 when much new data are present from more recent publications. This last omission is all the more obvious when a chapter solely denoted to PAVMs in Volume Ii includes the more recent references and contains some facts which contradict those given in the earlier section.

I was surprised by the absence of some conditions; I could find no mention of either the popliteal entrapment syndrome or cystic adventitial disease. Both these entities are causes of peripheral lower limb ischaemia in young adults and their recognition is important. However, the chapters on peripheral vascular magnetic resonance angiography and MR venography in the detection of venous thrombosis were, I thought, well-written and interesting.

J, Jackson

Skeletal Nuclear Medicine. Edited by D. Collier, L Fogelman and L Rosenthal. Mosby, UK, 1996, 474pp. £129.00.

Whilst magnetic resonance imaging has undertaken a large proportion of the applications previously carried out by skeletal scintigraphy, the technique retains an important role in several specific areas of orthopaedic imaging and still constitutes a high proportion of nuclear medicine examinations. Skeletal Nuclear Medicine, edited by Drs Collier, Fogelman and Rosenthal, is a comprehensive review of musculoskeletal scintigraphic applications. It comprises 21 chapters covering both the physics and clinical aspects of skeletal scintigraphy. An introductory short history of bone scanning provides an interesting backdrop to this comprehensive review. The authors address the importance of good technique and high quality imaging.

All the important areas of musculoskeletal are covered and there are separate chapters for paediatrics, trauma and sports medicine. A chapter is also devoted to specific orthopaedic problems, principally related to the postoperative patient.

Attention is paid to the relationship between scintigraphy and other imaging techniques, though, on occasion, the authors lend enthusiastic support for scintigraphy in areas where I feel MRI has now assumed the dominant role. Ultrasound also receives scant attention and this is particu- larly noticeable in the paediatric chapter where there is no mention of the use of ultrasound in children with irritable hips, and the authors quote plain films as a good way of assessing hip effusions, an opinion which I think many would find difficulty in agreeing with.

The majority of the chapters are well referenced, though I found several where the most recent reference cited was 1993, and another where data from a 1991 paper was cited as 'recent'. Perhaps, most importantly, the chapter entitled 'A multi-modality approach to bone imaging' quotes its most recent reference from 1991, which must be regarded as significantly out of date.

The book is well illustrated and images are of excellent quality. E. G. McNally

MR Cholangio-pancreatography. By Laghi and Catalano. Springer- Verlag, Berlin, 1997. 150pp. £148.00DM.

MR cholangiopancreatography (MRCP) has emerged rapidly as a non- invasive diagnostic method to evaluate the biliary and pancreatic ducts. The aim of this book is to provide a timely review of this evolving field, to explain and illustrate the radiological technique and to examine its clinical impact. The book achieves this through a series of short extensively illustrated chapters.

The book opens with a detailed description of the authors particular technique, placed in historical context, and with emphasis on the underlying physical principles. Other MRCP techniques are less fully covered, but this does not detract from the overall impression. This is followed by a useful summary of the normal MR anatomy of the biliary tree and the various congenital abnormalities. The next four chapters examine the role of MRCP in relation to the diagnosis of duct dilatation and obstruction, choledo- cholithiasis, and benign and malignant strictures. Taken together, these chapters map out the success story of MRCP to date, illustrating the technique in relation to other imaging modalities including nuclear medicine, ultrasound and computed tomography, and examining where MRCP may help to replace diagnostic ERCP. The subsequent chapter on MR pancreatography is realistically short, given the current state of the technique. The next two chapters cover the use of MRCP after biliary- enteric surgery and after liver transplant, and are followed by a final two page chapter on the advantages and disadvantages of MRCP with respect to ERCP. Tacked on the end, almost as an afterthought, are three 'appendices' each a short monograph on the use of MRCP prior to laparoscopic