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Radiology of Blunt Trauma of the Chest. Edited by P. Schnyder and M. Wintermark. Berlin, Springer-Verlag, 2000 ISBN: 3-540-66217-0. Cost: £55.00.
1006
CLINICAL RADIOLOGY
doi:10.1053/crad.2000.0613, available online at http://www.idealibrary.com on
Radiology of Blunt Trauma of the Chest. Edited by P. Schnyder and M. Wintermark. Berlin, Springer-Verlag, 2000 ISBN: 3-540-66217-0. Cost: £55.00. This hardback book is one of the Medical Radiology: Diagnostic Imaging and Radiation Oncology series produced by Springer-Verlag. The authors are both radiologists at the University Hospital in Lausanne, Switzerland. The Swiss have a strong reputation for producing quality work on this subject: Besson and Saegesser's A Colour Atlas of Chest Trauma and Associated Injuries emanated from this centre in 1982 and remains amongst the most highly respected texts on the subject to this day. Radiology of Blunt Trauma of the Chest has 149 pages and is organized into seven chapters. Five chapters are based on trauma to dierent anatomical areas within the chest (chest wall, diaphragm, pleura, lung parenchyma and mediastinum). There is a chapter at the start covering epidemiology and biomechanics. The book concludes with a chapter on paediatric chest trauma. The chapter on epidemiology and biomechanics is short and only gives a brief overview of these topics. This is ®ne as a refresher but the novice looking for more explanation, and the advanced reader wanting more detail, would both have to look elsewhere. The chapters covering the anatomical areas are much more comprehensive. Each is exhaustive in its coverage of the imaging ®ndings of blunt trauma and each is well referenced. The chapter on mediastinal trauma, for example, has 292 references. References are up to date, with a high proportion being from the late 1990s. There are 280 illustrations, which are all of high quality and, although most are of chest radiographs, there is a high proportion of CT images. The now widespread availability of spiral CT has had a dramatic impact on trauma imaging over the last 5±10 years and this development is well represented. Chest CT is now almost mandatory in cases of major blunt trauma and this has lead to greater accuracy in diagnosis and to a reduction in numbers of angiograms needing to be performed for suspected aortic injury. This book provides a comprehensive picture library of CT images of every type of blunt chest injury. A smaller number of angiographic, sonographic and contrast ¯uoroscopic studies are also included. In some sections, such as those
on aortic, cardiac and diaphragmatic injury, dierent imaging modalities are displayed side by side, which helps greatly in understanding the relative merits of each technique. The text contains a number of examples of unorthodox grammar and phrasing. Whilst it is usually perfectly clear what the authors are stating, the style of writing can occasionally be distracting. Words occur frequently that the British reader may be unfamiliar with. For example, the term pachypleuritis is used rather than post-traumatic pleural thickening and angor pectoris is used rather than angina. In the paediatric section it states that children often have serious internal injury with no associated chest wall injury because they have plastic thoracic cages! Not only does this sound bizarre; this is factually incorrect, as it is the elasticity, not plasticity of the young person's chest wall that leads to this phenomenon. On the clinical side the only omission of note concerns thoracic spinal injuries which do not feature at all. Thoracic spinal fractures are commonly associated with major blunt trauma, have a high incidence of neurological de®cit and their diagnosis is often delayed due to signs being masked by other injuries. Physicians need a high index of suspicion for thoracic spinal injuries and this topic's omission means an important educational opportunity has been missed. The ®rst chapter might have been more complete with a brief account of basic pathophysiology of chest trauma such as the factors leading to hypoxia, along with basic principles of treatment ± but maybe space constraints precluded this. It is good to see another book devoted to the radiology of chest trauma. The previous occupier of this niche, the excellent Radiology of Thoracic Trauma by Paul Stark, is now sadly out of print. Would I recommend this new book and, more pertinently, would I part with my own money for it? The answer on both counts is yes. Minor language anomalies notwithstanding, this is a very good book. It is comprehensive, up to date and well referenced. The high-quality illustrations provide a virtually complete catalogue of chest trauma imaging. Interested radiologists, cardiothoracic surgeons and accident and emergency physicians will all ®nd this book a very worthwhile investment. JOHN H. REYNOLDS
doi:10.1053/crad.2001.0758, available online at http://www.idealibrary.com on
Interventional Radiology Explained. I.S. Francis, A.F. Watkinson. ReMedica Publishing, London, 2000. Price: £20.00. This small soft-back book forms part of a series of guides for clinicians and GPs and sets out to explain the practice of interventional radiology. It would appear that the book is also aimed at general radiologists, who may wish to keep up to date. There is also a section dealing with patient information. The book is nicely produced with clear images and the authors are to be congratulated on condensing so much information into such a concise and accessible format. There are sections covering all aspects of radiological intervention and the descriptions of the techniques and their application is very much up to date. Despite the authors' intention to give information to non-interventional radiological colleagues they have attempted to go beyond this. In the ®rst section of the book there is a description of the process of informed consent. I would not have thought that this was appropriate in this setting. By the authors' own admission, it should be the interventional radiologist who explains the procedure and obtains the informed consent. The advice given in this section seems to be aimed at other interventional radiologists rather than those for whom the book
is written. Similarly the description of each technique is followed by a section on `Patient Information'. This is an attempt to condense the information contained on each procedure into a short user-friendly description of the techniques so that a patient may know what to expect. I am again unsure what this is doing in this book. It is surely up to interventional radiologists to produce and be comfortable with the information being given to patients. As this book is not aimed at them, there is a risk that patients will be being given information which bypasses the interventional radiologist and may not accord with local practice. It is however a rather more creditable attempt at providing patient information about interventional radiological procedures than I have seen produced elsewhere, and it would be a shame if, because of the way in which this book has been targeted, interventional radiologists themselves do not at least have the option to see this information and decide whether or not they would ®nd it useful for their departments. All in all I think this is a very creditable production. One last moan: the authors state that some interventional radiology suites have the facility to provide music `of the patient's choice'. Renal stenting accompanied by the Spice Girls; not in my department! IRVING WELLS
CLINICAL RADIOLOGY
doi:10.1053/crad.2000.0613, available online at http://www.idealibrary.com on
Radiology of Blunt Trauma of the Chest. Edited by P. Schnyder and M. Wintermark. Berlin, Springer-Verlag, 2000 ISBN: 3-540-66217-0. Cost: £55.00. This hardback book is one of the Medical Radiology: Diagnostic Imaging and Radiation Oncology series produced by Springer-Verlag. The authors are both radiologists at the University Hospital in Lausanne, Switzerland. The Swiss have a strong reputation for producing quality work on this subject: Besson and Saegesser's A Colour Atlas of Chest Trauma and Associated Injuries emanated from this centre in 1982 and remains amongst the most highly respected texts on the subject to this day. Radiology of Blunt Trauma of the Chest has 149 pages and is organized into seven chapters. Five chapters are based on trauma to dierent anatomical areas within the chest (chest wall, diaphragm, pleura, lung parenchyma and mediastinum). There is a chapter at the start covering epidemiology and biomechanics. The book concludes with a chapter on paediatric chest trauma. The chapter on epidemiology and biomechanics is short and only gives a brief overview of these topics. This is ®ne as a refresher but the novice looking for more explanation, and the advanced reader wanting more detail, would both have to look elsewhere. The chapters covering the anatomical areas are much more comprehensive. Each is exhaustive in its coverage of the imaging ®ndings of blunt trauma and each is well referenced. The chapter on mediastinal trauma, for example, has 292 references. References are up to date, with a high proportion being from the late 1990s. There are 280 illustrations, which are all of high quality and, although most are of chest radiographs, there is a high proportion of CT images. The now widespread availability of spiral CT has had a dramatic impact on trauma imaging over the last 5±10 years and this development is well represented. Chest CT is now almost mandatory in cases of major blunt trauma and this has lead to greater accuracy in diagnosis and to a reduction in numbers of angiograms needing to be performed for suspected aortic injury. This book provides a comprehensive picture library of CT images of every type of blunt chest injury. A smaller number of angiographic, sonographic and contrast ¯uoroscopic studies are also included. In some sections, such as those
on aortic, cardiac and diaphragmatic injury, dierent imaging modalities are displayed side by side, which helps greatly in understanding the relative merits of each technique. The text contains a number of examples of unorthodox grammar and phrasing. Whilst it is usually perfectly clear what the authors are stating, the style of writing can occasionally be distracting. Words occur frequently that the British reader may be unfamiliar with. For example, the term pachypleuritis is used rather than post-traumatic pleural thickening and angor pectoris is used rather than angina. In the paediatric section it states that children often have serious internal injury with no associated chest wall injury because they have plastic thoracic cages! Not only does this sound bizarre; this is factually incorrect, as it is the elasticity, not plasticity of the young person's chest wall that leads to this phenomenon. On the clinical side the only omission of note concerns thoracic spinal injuries which do not feature at all. Thoracic spinal fractures are commonly associated with major blunt trauma, have a high incidence of neurological de®cit and their diagnosis is often delayed due to signs being masked by other injuries. Physicians need a high index of suspicion for thoracic spinal injuries and this topic's omission means an important educational opportunity has been missed. The ®rst chapter might have been more complete with a brief account of basic pathophysiology of chest trauma such as the factors leading to hypoxia, along with basic principles of treatment ± but maybe space constraints precluded this. It is good to see another book devoted to the radiology of chest trauma. The previous occupier of this niche, the excellent Radiology of Thoracic Trauma by Paul Stark, is now sadly out of print. Would I recommend this new book and, more pertinently, would I part with my own money for it? The answer on both counts is yes. Minor language anomalies notwithstanding, this is a very good book. It is comprehensive, up to date and well referenced. The high-quality illustrations provide a virtually complete catalogue of chest trauma imaging. Interested radiologists, cardiothoracic surgeons and accident and emergency physicians will all ®nd this book a very worthwhile investment. JOHN H. REYNOLDS
doi:10.1053/crad.2001.0758, available online at http://www.idealibrary.com on
Interventional Radiology Explained. I.S. Francis, A.F. Watkinson. ReMedica Publishing, London, 2000. Price: £20.00. This small soft-back book forms part of a series of guides for clinicians and GPs and sets out to explain the practice of interventional radiology. It would appear that the book is also aimed at general radiologists, who may wish to keep up to date. There is also a section dealing with patient information. The book is nicely produced with clear images and the authors are to be congratulated on condensing so much information into such a concise and accessible format. There are sections covering all aspects of radiological intervention and the descriptions of the techniques and their application is very much up to date. Despite the authors' intention to give information to non-interventional radiological colleagues they have attempted to go beyond this. In the ®rst section of the book there is a description of the process of informed consent. I would not have thought that this was appropriate in this setting. By the authors' own admission, it should be the interventional radiologist who explains the procedure and obtains the informed consent. The advice given in this section seems to be aimed at other interventional radiologists rather than those for whom the book
is written. Similarly the description of each technique is followed by a section on `Patient Information'. This is an attempt to condense the information contained on each procedure into a short user-friendly description of the techniques so that a patient may know what to expect. I am again unsure what this is doing in this book. It is surely up to interventional radiologists to produce and be comfortable with the information being given to patients. As this book is not aimed at them, there is a risk that patients will be being given information which bypasses the interventional radiologist and may not accord with local practice. It is however a rather more creditable attempt at providing patient information about interventional radiological procedures than I have seen produced elsewhere, and it would be a shame if, because of the way in which this book has been targeted, interventional radiologists themselves do not at least have the option to see this information and decide whether or not they would ®nd it useful for their departments. All in all I think this is a very creditable production. One last moan: the authors state that some interventional radiology suites have the facility to provide music `of the patient's choice'. Renal stenting accompanied by the Spice Girls; not in my department! IRVING WELLS