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Abdominal echography: Ultrasound in the diagnosis of abdominal conditions
Book Reviews
159
Ultrasound in Med. & Bio/.,Vol.2, p. 159.PergamonPress,1976.Primedin GreatBritain.
ABDOMINAL ECHOGRAPHY: ULTRASOUND IN THE DIAGNOSIS OF ABDOMINAL CONDITIONS By E. BARNETTand P. MORLEY.Butterworth & Co., London, 1974. 138 pp. 143 illus. $17.35. This small volume is intended to fill an increasing void in the rapidly expanding specialty of diagnostic ultrasound. Barnett and Morley's paper back manual (137pp. text) is the first English language text to deal solely with the application of ultrasonic B-scanning to disorders of the abdomen and pelvis. While the overall quality of the book is high, preparation time and some minor oversights have served to slightly diminish its value. The book opens with a brief but readable account of ultrasonic physics. Although gray scale is mentioned, the method of achieving it with short and variable persistence tubes mentioned here is certainly not the only method available. The brief paragraph on Doppler techniques gives no hint whatsoever as to their clinical application and probably should have been omitted. The second chapter deals with general observations about B-scanning and expresses clearly the British preference for altering frequency, rather than sensitivity, to assess the consistency of a mass. The TVG (Time Varied Gain) curve suggested by the authors will seem peculiar to most readers as it tends to resemble that used for cardiac studies at many institutions. The authors suggest that most ultrasonic equipment is calibrated to either 1600 m/s or 1540 m/s. To the reviewer's knowledge, only the Diasonograph (Nuclear Enterprises) utilizes the former. The chapter concludes with a section on normal anatomy of the abdomen and pelvis. Unfortunately, this important aspect is treated with six scans and four paragraphs of text. The scans are of high quality and are accompanied with excellent line diagrams, but the subject itself defies description in this limited manner. The following two chapters deal with the liver, gallbladder, spleen, pancreas, adrenals, great vessels, retroperitoneal space and miscellaneous fluid collections. Most of this 30 pages is occupied with the illustrations which, although excellent, would have been better with accompanying correlative material (x-rays, etcetera). Also, information concerning the accuracy of the technique in the assessment of some of these conditions (gallstones, lymph nodes) would seem appropriate. The chapter on the urinary tract, which nearly equals in length the sum of the previous two, is the showpiece of the text. The
authors' extensive clinical experience in this area clearly shows in both the illustrations and the text. By itself it is probably the best written summary of genitourinary ultrasound available to date. Some will then be surprised that the remaining half of the book, for which the title is, "'Abdominal Echography". is devoted to obstetrical and gynecological disorders. While the authors are clearly entitled to include whatever they want. the greater need at the moment is in abdominal disorders and the title could be construed as misleading. The obstretrical material in Chapter 6 is well organized, illustrated, and described. Again, the reference to speed of sound in the fetal skull being 1600 m/sec, is raised--still a point of debate among experienced obstretrical ultrasonographers. Of notable interest is that no real-time ultrasonic work is referred to throughout this chapter. The book concludes with a chapter outlining a wide variety of pelvic masses. Only three references accompany this chapter. In summary, this is a book with both positive and negative features. The positive features include the high quality of the illustrations, the organization of the material and the clarity of its somewhat abbreviated text. Its negative aspects include the somewhat misleading title, the relative weakness of the abdominal section compared with the renal and pelvic chapters, and omission of reference to both gray scale and real time scanning--both significant advances in soft tissue imaging, This latter is entirely understandable in view of inevitable time lapse between conception and publication. In the main, the positive points outweigh the negative and the book achieves its purpose which as stated by the editor is to, " give clinicians" a "survey of the role of diagnostic radiology in different spheres of clinical practice and to provide radiologists in training with a handbook from which they can quickly learn and to which they can readily refer." Purchase of the book by such individuals is therefore recommended.
GEORGE R. LEOPOLD
159
Ultrasound in Med. & Bio/.,Vol.2, p. 159.PergamonPress,1976.Primedin GreatBritain.
ABDOMINAL ECHOGRAPHY: ULTRASOUND IN THE DIAGNOSIS OF ABDOMINAL CONDITIONS By E. BARNETTand P. MORLEY.Butterworth & Co., London, 1974. 138 pp. 143 illus. $17.35. This small volume is intended to fill an increasing void in the rapidly expanding specialty of diagnostic ultrasound. Barnett and Morley's paper back manual (137pp. text) is the first English language text to deal solely with the application of ultrasonic B-scanning to disorders of the abdomen and pelvis. While the overall quality of the book is high, preparation time and some minor oversights have served to slightly diminish its value. The book opens with a brief but readable account of ultrasonic physics. Although gray scale is mentioned, the method of achieving it with short and variable persistence tubes mentioned here is certainly not the only method available. The brief paragraph on Doppler techniques gives no hint whatsoever as to their clinical application and probably should have been omitted. The second chapter deals with general observations about B-scanning and expresses clearly the British preference for altering frequency, rather than sensitivity, to assess the consistency of a mass. The TVG (Time Varied Gain) curve suggested by the authors will seem peculiar to most readers as it tends to resemble that used for cardiac studies at many institutions. The authors suggest that most ultrasonic equipment is calibrated to either 1600 m/s or 1540 m/s. To the reviewer's knowledge, only the Diasonograph (Nuclear Enterprises) utilizes the former. The chapter concludes with a section on normal anatomy of the abdomen and pelvis. Unfortunately, this important aspect is treated with six scans and four paragraphs of text. The scans are of high quality and are accompanied with excellent line diagrams, but the subject itself defies description in this limited manner. The following two chapters deal with the liver, gallbladder, spleen, pancreas, adrenals, great vessels, retroperitoneal space and miscellaneous fluid collections. Most of this 30 pages is occupied with the illustrations which, although excellent, would have been better with accompanying correlative material (x-rays, etcetera). Also, information concerning the accuracy of the technique in the assessment of some of these conditions (gallstones, lymph nodes) would seem appropriate. The chapter on the urinary tract, which nearly equals in length the sum of the previous two, is the showpiece of the text. The
authors' extensive clinical experience in this area clearly shows in both the illustrations and the text. By itself it is probably the best written summary of genitourinary ultrasound available to date. Some will then be surprised that the remaining half of the book, for which the title is, "'Abdominal Echography". is devoted to obstetrical and gynecological disorders. While the authors are clearly entitled to include whatever they want. the greater need at the moment is in abdominal disorders and the title could be construed as misleading. The obstretrical material in Chapter 6 is well organized, illustrated, and described. Again, the reference to speed of sound in the fetal skull being 1600 m/sec, is raised--still a point of debate among experienced obstretrical ultrasonographers. Of notable interest is that no real-time ultrasonic work is referred to throughout this chapter. The book concludes with a chapter outlining a wide variety of pelvic masses. Only three references accompany this chapter. In summary, this is a book with both positive and negative features. The positive features include the high quality of the illustrations, the organization of the material and the clarity of its somewhat abbreviated text. Its negative aspects include the somewhat misleading title, the relative weakness of the abdominal section compared with the renal and pelvic chapters, and omission of reference to both gray scale and real time scanning--both significant advances in soft tissue imaging, This latter is entirely understandable in view of inevitable time lapse between conception and publication. In the main, the positive points outweigh the negative and the book achieves its purpose which as stated by the editor is to, " give clinicians" a "survey of the role of diagnostic radiology in different spheres of clinical practice and to provide radiologists in training with a handbook from which they can quickly learn and to which they can readily refer." Purchase of the book by such individuals is therefore recommended.
GEORGE R. LEOPOLD