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Dynamic radiology of the abdomen: normal and pathologic anatomy

Computed body tomography Edited by Joseph K T Lee, Stuart S Sagel, and Robert J Stanley. (Pp. 564; illustrated; $99.20.) New York: Raven Press, 1983. Radiology as a diagnostic discipline is based almost entirely on defining normal anatomy, knowing the variations of normal, and thereby recognising the abnormal. Without the recognition of anatomical abnormalities it is impossible to even suggest any pathology. The merit of computed tomography lies in the anatomical detail it displays of the full range of body organs including the soft tissues of the abdomen and mediastinum, lungs, brain, and bone. The other imaging modalities have advantages in particular regions; ultrasound in obstetrics and cardiovascular anatomy, nuclear magnetic resonance in the brain, isotope studies in functional images but for versatility and total body displays, computed tomography cannot as yet be matched by any other single method. Hence the increasingly widespread use of computed tomography in clinical investigation in spite of the cost of both the apparatus and its revenue consequences. In gastroenterology it is most useful in the solid organs, notably in the pancreas, liver, spleen, and in lymph node disease. Even in the gastrointestinal tract, however, visualising the thickness of the walls of hollow viscera can also be crucial. More importantly, computed tomography shows the size and position of abscesses, particularly those in and around the liver, and has become yet another stimulqs to percutaneous cytology and abscess drainage, avoiding laparotomy in many cases. It is therefore a pleasure to find a text on body computed tomography that clearly details and portrays the anatomical possibilities of the technique and relates so elegantly to the diagnostic potentials of the method. It has been realised largely by the efforts of the team at Mallinckrodt Institute of Radiology at St Louis who have had an extensive, combined experience. The format, the illustrations, and even the text with its inevitable Americanisms is of the highest order. Any criticisms that may be levelled at the biased historical appraisal or parochial emphasis would be, to say the least, irrelevant. In the final analysis this is a fine book, to be highly recommended and absolutely essential for radiologists and clinicians.