General and Vascular Ultrasound: Case Review Series

Abstract

General and Vascular Ultrasound, by William Middleton, is one in a series of Case Review books designed to provide and reinforce basic radiology principles through a question-and-answer format. The book incorporates three chapters of sequentially more difficult cases and questions, each of which contains pertinent ultrasound (US) images, including many with color plates. The book contains a glossary for quick reference because the cases within each chapter do not follow any particular order. The text itself is 230 pages and includes 211 cases. The book is a paperback; however, the quality of the images and printing is excellent. The first chapter, entitled “Opening Round,” reviews much of the normal basic anatomy and principles of US, including vascular examinations. The cases in this chapter are the textbook-type cases one would expect to encounter in general practice. The vascular cases include an aortic aneurysm, deep vein thrombosis, normal carotid arteries, and a pseudoaneurysm. There are several examples and discussions of vascular principles such as aliasing artifacts, high-resistance waveforms, and beam steering. The second chapter, “Fair Game,” contains pathology and concepts that are slightly more advanced, yet still within the realm of day-to-day practice, and certainly commonly seen every spring within the confines of a well-known Southern hotel. The vascular cases and principles include color versus power Doppler imaging, subclavian steal, subclavian and renal vein obstruction, variant hepatic vascular anatomy, spectral Doppler measurements, Doppler angle, and parvus-tardus waveforms. Although the scope is limited by the selected cases and the text is not exhaustive, each case does have references listed and is cross-referenced to Mosby's Ultrasound: The Requisites. The discussion does serve as a solid foundation for each related topic. The third chapter, “Challenge,” is just that. The nonvascular cases include many of the “zebras” about which we read but rarely encounter. The vascular cases require the reader to use basic principles and an understanding of abnormal waveforms to make more complex diagnoses involving renal and carotid disease and transjugular intrahepatic portosystemic shunts. Unfortunately, the book does not include cases or discussions about pulsevolume recordings or other noninvasive vascular procedures commonly incorporated in most vascular laboratories. Although not designed to be an all-encompassing textbook of general and vascular US, the book does clearly cover a wide range of US cases. The book is easy to read and covers basic anatomy and the principles of US while captivating the more-experienced reader with challenging cases. The question-and-answer format provides useful information and reinforces the reader's knowledge base in a nondidactic format. The book would represent a wonderful review for radiology residents preparing for their board examinations. In addition, because each case study is unique, even a more experienced practicing radiologist would find it beneficial as an quick, easy-to-read refresher.