Diagnostic and Interventional Neuroradiology: A Multimodality Approach

Klaus Sartor, ed. Stuttgart: Thieme; 402 pages. $99.00.

This multiauthored text provides a comprehensive review of neuroradiology targeted toward both the clinician and young neuroradiologist. There are five sections that cover the major aspects of a neuroradiologic practice. The book is concise and conveys adequate technical information about various radiologic modalities in addition to imaging findings in almost all clinical abnormalities.

The first section pertains to craniocerebral diseases and comprises the bulk of the book. It is well organized into multiple subsections. The introductory chapter is devoted to basic principles, technical aspects, and applications of the various imaging modalities. An attempt has been made to provide a comprehensive description of various imaging techniques. The MR imaging section, however, lacks detailed coverage of newer MR imaging techniques such as MR spectroscopy, CSF flow, and diffusion and perfusion imaging. Carotid Doppler ultrasonography has not been elaborated. The schematic drawings of normal skull anatomy and its variants, as well as vascular anatomy, are particularly well illustrated and instructive. Toward the end of the introduction, the MR findings of normal brain maturation are particularly helpful for the pediatric neuroradiologist.

The introduction is followed by multiple subsections on craniocerebral diseases, which include most of the major disease processes encountered in clinical practice. Relevant neuropathology and clinical features of various disease entities and their differential diagnosis are well discussed. Radiologic findings are elaborated for each clinical entity. All the sections are comprehensive and adequately illustrated.

The second section on spinal diseases has a similar format. Although it covers basic imaging techniques, it lacks state-of art techniques in spinal MR imaging. Newer sequences in spinal MR imaging, such as diffusion-weighted and dynamic CSF flow-sensitive techniques and their clinical applications, have not been emphasized. The last section on miscellaneous diseases of the spinal column lacks illustrations, but the other sections on spinal diseases are well written and informative.

The third section briefly discusses CT and MR findings of few neuromuscular disorders.

The last part of the book consists of two sections emphasizing the role of a radiologist as a therapist. Angiography and various endovascular interventional procedures such as angioplasty, embolization, and thrombolysis are described in detail. Indications and techniques of vertebroplasty, facet injections, and other procedures for management of pain are briefly outlined. Common vascular disorders and their treatment are well described and relevant for this comprehensive book.

The book is properly organized, well illustrated, and easy to use. Most of the images are of high quality. Salient clinical and radiologic features are highlighted in each chapter. The layout and descriptive text makes for an easy and quick review. The captions are brief and well written. Important technical details and indications of each imaging technique are well summarized at the end of each section. The chapters are well referenced and up to date.

Description of normal CT and MR anatomy was cursory and could have been presented in more detail. As a suggestion for future editions, the authors might consider including a separate chapter on normal anatomy .The book also lacks some of the newer special MR imaging methologies such as diffusion-weighted, spectroscopic, and CSF flow imaging techniques in various cerebral and spinal disease states, and this is one of the major drawbacks of this book. It certainly would be worthwhile to incorporate these recent advances and state-of-the-art techniques in future editions of this textbook, because these are becoming an important part of current MR diagnostic imaging. These are minor points, however, in an otherwise well-planned book.

Overall, this is a highly informative, clinically relevant, useful, and great teaching book. It should be read cover to cover by all trainees and would be a welcome addition to any radiology library. It fulfills its intended purpose of serving as a concise reference covering all aspects of diagnostic and interventional neuroradiology, thus making it an excellent and ready resource for radiology residents and fellows reviewing for board examinations as well as clinicians dealing with neuroradiologic imaging.