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Atlas of neonatal anatomy
381
Atlas of Neonatal Anatomy by J.P. Lassau, D. Bastian, E.A. Cabanis Masson Publishing USA Inc., Plainview, 133 pages, US-$55.00
and L. Pourcelot NY, 1982
The subtitle of the book is ‘Correlation of Gross Anatomy, Computed Tomography and Ultrasonography’ and this gives a more accurate indication of the objectives of its four French authors. The major part of the atlas depicts 43 transverse sections, each 6 mm in thickness through the head, trunk and upper thigh of the term fetus. A photograph and a labelled diagram of each of these slices are represented on facing pages. These are supplemented by at least one, and as many as five computed tomographs of the particular specimen. Occasional ultrasound pictures are also included. Each pair of facing pages carries a schematic diagram showing the precise level in the fetus the transverse slice has been obtained. A key to the numbered anatomical landmarks is provided in both English and French. Because of artifacts produced in the brain tissue by autolysis and freezing, a live neonate was employed to show the computerised tomographic imaging of the intracranial anatomy. There is a separate section devoted to the anatomy of the female pelvis for comparison with the otherwise male anatomy described elsewhere. Finally there are a few sagittal sections of a male newborn described in an identical manner to the transverse sections. An anatomical index completes the book. The format of the atlas is clear, logical and pleasingly large (approximately 20 X 30 cm). The diagrams are extremely well drawn and labelled and are a great credit to Dr. Bastian. The authors acknowledge in their introduction that post-mortem decomposition, freezing and the lack of circulation make certain artifacts of the tomographs and sonographs unavoidable. Personally, I do not find these intrusive in the illustrations which have been chosen but it may well be that they could be a cause of minor confusion when the book is used as a reference to a live patient in a clinical situation. I would have welcomed more ultrasonographs or ‘echographic’. The fact that these are orientated looking cranially whilst the tomographs are directed caudally is an annoyance. A serious criticism which the practising clinical ultrasonagrapher is bound to make is the caudally directed views of the tomographs of the fetal body. Whilst this is the conventional way of examining the head, the bodies of live patients are invariably examined looking cranially. I have no doubt that some readers will regret the authors have preferred uniformity of presentation of the orientation of the tomographs to the advantages of mimicking the clinical situation. The photographs of the gross specimen slices are poor and the effects of autolysis and ice crystal formation are apparent. The combination of an American translating French gives the text a rather peculiar and distinctive flavour, but I am bound to say that it is unambiguous and easier to read than some literature in its original form. The text is, in any case, almost wholly confined to a five page introduction. The greatest appeal of this excellent book is that it attempts to fulfill a modern need. Anatomy is traditionally preoccupied with the embryo or the adult and not the newborn. It is traditionally taught in three dimensions. It is also taught from an
382
anterior, posterior or lateral viewpoint. Whilst this is acceptable for the interpretation of orthodox radiographs, the development of computerised axial tomography has forced the clinician to view the human body in the format of two dimensional transverse slices. The authors are to be congratulated in perceiving the need for an anatomical atlas orientated in this fashion. The growing number of radiologists attached to maternity and neonatal units who have become part or full time ultrasonographers may justly regard this book as a basic reference for their clinical practice. The price should be no discouragement to its acquisition. I anticipate that this book will prove popular enough to run to future editions. In this event there are improvements which could be made. Despite the practical difficulties I would urge the authors to replace their material as far as possible with fresher and preferably unfrozen tissue. All the fetuses used weighed approximately 3.3 kg but ultrasonography in a clinical setting is often preoccupied with fetuses weighing 1 or even 2 kg less than this. It would be invaluable to have more information on the changes in anatomical relationships manifest in the last trimester of gestation. There is also scope for a book depicting pathological anatomy by ultrasound at this age. Despite these reservations the clinical need for a newborn atlas of this type has been largely fulfilled. I am sure it will stimulate rival publications with similar aims but for the present it has none. A.J. BARSON
Atlas of Neonatal Anatomy by J.P. Lassau, D. Bastian, E.A. Cabanis Masson Publishing USA Inc., Plainview, 133 pages, US-$55.00
and L. Pourcelot NY, 1982
The subtitle of the book is ‘Correlation of Gross Anatomy, Computed Tomography and Ultrasonography’ and this gives a more accurate indication of the objectives of its four French authors. The major part of the atlas depicts 43 transverse sections, each 6 mm in thickness through the head, trunk and upper thigh of the term fetus. A photograph and a labelled diagram of each of these slices are represented on facing pages. These are supplemented by at least one, and as many as five computed tomographs of the particular specimen. Occasional ultrasound pictures are also included. Each pair of facing pages carries a schematic diagram showing the precise level in the fetus the transverse slice has been obtained. A key to the numbered anatomical landmarks is provided in both English and French. Because of artifacts produced in the brain tissue by autolysis and freezing, a live neonate was employed to show the computerised tomographic imaging of the intracranial anatomy. There is a separate section devoted to the anatomy of the female pelvis for comparison with the otherwise male anatomy described elsewhere. Finally there are a few sagittal sections of a male newborn described in an identical manner to the transverse sections. An anatomical index completes the book. The format of the atlas is clear, logical and pleasingly large (approximately 20 X 30 cm). The diagrams are extremely well drawn and labelled and are a great credit to Dr. Bastian. The authors acknowledge in their introduction that post-mortem decomposition, freezing and the lack of circulation make certain artifacts of the tomographs and sonographs unavoidable. Personally, I do not find these intrusive in the illustrations which have been chosen but it may well be that they could be a cause of minor confusion when the book is used as a reference to a live patient in a clinical situation. I would have welcomed more ultrasonographs or ‘echographic’. The fact that these are orientated looking cranially whilst the tomographs are directed caudally is an annoyance. A serious criticism which the practising clinical ultrasonagrapher is bound to make is the caudally directed views of the tomographs of the fetal body. Whilst this is the conventional way of examining the head, the bodies of live patients are invariably examined looking cranially. I have no doubt that some readers will regret the authors have preferred uniformity of presentation of the orientation of the tomographs to the advantages of mimicking the clinical situation. The photographs of the gross specimen slices are poor and the effects of autolysis and ice crystal formation are apparent. The combination of an American translating French gives the text a rather peculiar and distinctive flavour, but I am bound to say that it is unambiguous and easier to read than some literature in its original form. The text is, in any case, almost wholly confined to a five page introduction. The greatest appeal of this excellent book is that it attempts to fulfill a modern need. Anatomy is traditionally preoccupied with the embryo or the adult and not the newborn. It is traditionally taught in three dimensions. It is also taught from an
382
anterior, posterior or lateral viewpoint. Whilst this is acceptable for the interpretation of orthodox radiographs, the development of computerised axial tomography has forced the clinician to view the human body in the format of two dimensional transverse slices. The authors are to be congratulated in perceiving the need for an anatomical atlas orientated in this fashion. The growing number of radiologists attached to maternity and neonatal units who have become part or full time ultrasonographers may justly regard this book as a basic reference for their clinical practice. The price should be no discouragement to its acquisition. I anticipate that this book will prove popular enough to run to future editions. In this event there are improvements which could be made. Despite the practical difficulties I would urge the authors to replace their material as far as possible with fresher and preferably unfrozen tissue. All the fetuses used weighed approximately 3.3 kg but ultrasonography in a clinical setting is often preoccupied with fetuses weighing 1 or even 2 kg less than this. It would be invaluable to have more information on the changes in anatomical relationships manifest in the last trimester of gestation. There is also scope for a book depicting pathological anatomy by ultrasound at this age. Despite these reservations the clinical need for a newborn atlas of this type has been largely fulfilled. I am sure it will stimulate rival publications with similar aims but for the present it has none. A.J. BARSON