Book review

Abstract

Magnetic Resonance in the Diagnosis of C.N.S. Disorders Vaso Antunoviæ, Gradimir Dragutinoviæ, Zvonimir Leviæ, and Miroslav Samadziæ, with chapter contributions from nine experts in the field Stuttgart, New York, Rome, Thieme Verlag, CIC Edizioni Internationali, 2001 $129; pp 317; 330 illustrations (black & white) Daniel T. Boll M.D.*, * Department of Radiology University Hospitals of Cleveland and Case Western Reserve University. The introduction of magnetic resonance imaging (MRI), as the authors of this text propose, led to revolutionary improvements in the visualization, localization, and identification of the spatial relationships of pathologic processes in the central nervous system. The intent of the authors in creating this text was to assemble a review of the clinical characteristics along with the MRI findings in the neurological and neurosurgical conditions seen in their experience at their clinical institution in Belgrade, Serbia. The senior authors of this 317 – page text have made many contributions to Serbo – Croatian literature over the last two decades and have recently published several articles in international journals. The text is divided into two main sections covering the brain and cranio – cervical junction as well as the spine. The first section is further subdivided into a general section, mainly emphasizing MR techniques, and a specialized section. The general section however primarily suffers from a very weak translation. The authors state that spin echo sequences are most appropriate for the majority of cerebral MR imaging, and do not endorse sequences such as FLAIR or gradient echo at all. The specialized part of the first section is further subdivided into chapters addressing cerebral malformations, diseases of cerebro – vascular origin, trauma, and infections as well as degenerative diseases and tumors of the hemispheres, posterior cranial fossa, cranio – cervical junction, hypophysis, and those tumors with intracranial propagation. Each chapter, written by a different contributor, is similar in structure in that it utilizes a pathologic approach for the diseases. Unfortunately, this led to repetition and redundant information. The summaries of pathology and potential therapy are short and adequate, but medical terms are used inconsistently. The image quality of the spin echo sequences presented in the figures suffers from inappropriate window settings, coil position, missing fat saturation, pronounced aliasing, and motion artifact. The literature cited in these chapters was written a decade ago and therefore lacks developments that are integral components of current MRI procedures. The chapter describing cerebral malformations gives an adequate and illustrated overview of the current textbook knowledge but lacks some rare but important syndromes. The chapters covering pathologies of cerebrovascular and traumatic origin overestimate the significance of conventional angiography while underestimating the importance of MRI. The detection of hemosiderin is realized most efficiently by utilizing gradient echo sequences, whereas mapping of the calculated apparent diffusion coefficients (ADC) is useful for improving the detection and characterization of infarctions; none of this information is mentioned in the relevant chapters. The chapter illustrating intracranial infections describes numerous aspects of cerebral involvement, even mentioning the cerebral impact of AIDS. Imaging of neurodegenerative diseases of the brain described in the next chapter are much better visualized with inversion recovery sequences such as FLAIR, unfortunately not utilized for illustration here. Nevertheless, the theoretical knowledge presented is this chapter is well presented and accurate. Tumors of various cerebral locations, as specified in the next five chapters, are thoroughly explained, although regrettably without mention of spectroscopy, or high resolution or inversion recovery imaging of the orbit or hypophysis. In more condensed form, temporal lobe epilepsy, MR Angiography (MRA), and MRI in infants are described in the next three chapters. Most of the causes of epilepsy originating in the temporal lobe are mentioned and illustrated. MR angiography focusing on the cervical and intracranial vessels is described only as a contrast enhanced technique, whereas intracranial time of flight angiography data is not presented in this chapter. The relatively brief second main section covering malformations, vascular diseases, trauma, demyelization, tumors, and angiography of the spine, suffers from repetition of previously presented information. In summary, although containing many useful facts regarding the vast and highly complex field of central nervous system disorders, this volume cannot be recommended as a source for current information concerning relevant MR imaging techniques for the evaluation of these diseases.