202 CLINICAL RADIOLOGY

BOOK REVIEWS

Modern Thin-Section Tomogrnphy. By A. BERRET, S. BRUNNER and G. E. VALVASSORI. Published by Charles C. Thomas, 1973. Price $26'50.

This book consists essentially of a number of scholarly chapters on the history of tomography, physics, equipment, various usages and radiation dosage. Forty-seven pages arc given to the first three aspects, 172 to the skull, sinuses and temporo-mandibular joint with particular emphasis on the temporal bone (82 pages). The larynx occupies 19 pages and the spine and gas myelography, 33. It seems a great pity that the chest and abdomen are compressed into 30 pages (5 concerned with transverse axial tomography) as these are the areas which are most commonly romp- graphed.

The book is well printed, and well arranged with mostly very clear illustrations, but unfortunately suffers from a certain amount of historical repetition in each of its sections.

Whilst the book gives a lot of very useful information on the skull and temporal bone and shows, e.g. detailed demonstration of tumours, erosions and fractures, it is not so helpful to the practical radiologist who often wishes to look up some point quickly. Cross references to the various chapters (regarding equipment or historical references) would have been useful. Even in the discussion about tumours of the maxillary sinuses the important point about orbital involvement, which often leads to blindness or enucleation of the eye before or following radiotherapy, is not considered.

For the ordinary radiologist who wishes to look up 'what is the best equipment' to buy there is no mention that tomographic attachments and that machines which have detachable tube heads, e.g. for doing upright chest radiography etc., often have considerable tube-wobble and unwanted movement. On page 29 one reads that linear devices are disappearing and are not to be discussed - but where can one find a more robust apparatus than the now old fashioned Siemens 'Planigraph'? The coupling rods of many of the more modern machines are often far from robust, a point which is certainly not true of the new C.G.R. 'Stratomatie' which is very well made but only briefly discussed. There are also several new cranial tomographic machines including the G.E 'Neurotome' and Picker 'Isotope' which are not mentioned, neither is the present French custom of combining linear tomography with many fluoroscopic and Bucky tables. Certainly several good linear tomographic machines are still being made by European manufacturers.

Vallebona makes a very good point on page 20 about the direct relationship between the organ or part to be blurred and the direction of the tomographic sweep, a point which is re-iterated on the temporal bone in Chapter 6. It is also noted by the authors of chapter 9, who incidentally have not

used the Radiotome for tomography of the larynx for over 5 years.

In the historical section many names and references are given, but often the reader is left with the question - what did the 'authors-referred-to' actually do? An example of this is: what is Baese's method on page 7?

The reviewer feels that very much more of the book could well have been devoted to practical points about chest and renal tomography, which occupy so much of a radiologist's time. Although tuberculosis is declining, the incidence of carcinoma of the lung is still increasing. Many also believe that tomography should always be available for intravenous pyelography and the reviewer considers this essential for patients with renal failure, suspected mass or atrophic lesions or whenever the details of renal anatomy are not readily seen on simple Bucky views.

Despite all its faults it is a useful book, particularly for the sections on the skull and temporal bones, and for its references. It will find its way onto the library shelves of every larger x-ray department.

F. W. WRIGHT

Selective Bronchial and Intercostal Arteriography. By A. S. J. ]3OTENGA. Published by H. E. Stenfert Kroese N.V. Holland. Price Dfl. 96,-- (excluded Dutch Taxes).

This is an excellent review of the anatomy and the radio- logical demonstration of the bronchial, and to a lesser extent, of the intercostal arteries. The world literature is fully reviewed, particularly with reference to the detailed origin, course and distribution of these vessels. This is followed by a short section on the radiological technique of their demons- tration by selective arteriography.

The author then reviews his personal experience in 84 patients, resulting in 143 selective bronchial and 120 selective intercostal artcriograms. In only 7 patients was there failure to visualise a bronchial artery. Among the 84 patients were 23 with primary lung tumours, 18 with tuberculous lesions, 11 with bronchiectasis and 11 with emphysema, together with an occasional example of several other pathologies. The radiographic quality is extremely good, the text is always dear, there is a full international bibliography and a detachable appendix tabulating the anatomical findings collected from the world literature. There are occasional statements which one might reasonably question - e.g. ' that the rich bronchial blood supply of the hamartoma is due to secondary infection', but this is metic- ulous work, based on an extensive personal experience and a thorough review of the world literature. For any project involving bronchial arteriography, this is an essential contribution.

R. G. GRAXNG~R