Textbook Of Radiology Research Articles

Book reviewsAn Atlas of Normal Roentgen Variants that may Simulate Disease. By KeatsTheodore E., pp. xv + 616, ill., 2nd ed., 1979 (Year Book Medical Publishers, Chicago/London), £7·25. ISBN 0–8016–1493–7

One of the best parameters for assessing the value of individual volumes in a library is the rate at which they reach a state of dilapidation. When applied, it reveals the two most valuable books to be a well-known standard text book of radiology and the first edition of this work by Theodore E. Keats. The popularity of the latter is easy to explain.

Book reviewsDouble Contrast Studies of the Gastrointestinal Tract with Endoscopic Correlation. By LauferIgor, pp. xii+723, 1979 (W. B. Saunders Co. Ltd., Eastbourne, Sussex), £45·50. ISBN 0–7216–5734–6

Dr Laufer has, with the aid of a number of distinguished contributors, produced a magnificent textbook of gastro-intestinal radiology. In the introduction Laufer states that the main purpose of the book “is to provide radiologists with the information they need to perform and interpret double contrast examinations”.

Book reviewA Textbook of Radiology. Edited by SuttonDavid, 2nd edn, pp. xiii + 1,376, 1975 (Edinburgh, London and New York, Churchill Livingstone), £25.

There are those who believe that a single-volume textbook has no place in a wide-ranging subject such as radiology. Certainly there are problems; every section is inevitably compressed, and it is not easy to give an adequate picture of individual disease processes. There are also difficult decisions on which conditions or procedures to mention, particularly when the aim is, as the author's foreword indicates, to be both comprehensive and concise. Yet the success of the first edition of this book shows that Dr. Sutton was right in his belief that there was a need for such a work, and after being out of print for two years the second edition has already enjoyed a wide scale.

A Textbook of Radiology

In many clinical fields, available texts are explicitly oriented towards medical students, and are therefore simple, succinct, and necessarily abbreviated. The larger works in the field tend to be reference volumes—detailed, comprehensive, and incorporating not only the experience of the authors but the best of the pertinent literature, both past and present. It is David Sutton's contention that these two approaches leave a gap that has not been satisfactorily filled, at least in radiology. In his A Textbook of Radiology , therefore, he has focused on an intermediate area useful to advanced trainees and younger radiologists in practice, while incorporating all divisions of radiology into a single volume. The first edition of this text appeared in 1969 and was greeted with enthusiasm. Now, six years later, the second edition represents an updating of the first, with new chapters and many new illustrations. Although it is a single volume, it is

Gastrointestinal Radiology in Pediatrics

This is the first complete radiology textbook dealing exclusively with the gastrointestinal tract of infants and children that has been published in this country since 1959. Individual chapters take up each segment of the intestinal tract, and there are sections on the abdomen and peritoneal cavity, the liver and biliary tract, and the pancreas. The final chapter, contributed by Dr. Eugene Klatte, is devoted to a brief discussion of the technical aspects of visceral angiographic procedures. Current references (some as recent as 1974) follow each chapter and are subdivided according to individual topics. The vast majority of the more than 400 illustrations are of good quality. This is a notable achievement when one takes into account the difficulties involved in obtaining highquality roentgenograms of the intestinal tract in young children. Excellent clinical and pathophysiological material is included. A few minor omissions include the following: The importance of a preliminary film

Analysis of Roentgen Signs in General Radiology

This classic textbook of diagnostic radiology has been expanded from the two volumes of the previous edition to three volumes, 1,915 pages and 1,091 illustrations. The goal of these volumes, according to the author's preface, is to include as many roentgenographic signs as space would allow along with optimum illustrations, explanation of these signs, and a review of the literature. In general, the author has succeeded admirably and the result is a rather complete textbook of diagnostic radiology that is particularly well suited for the resident in radiology. This publication is perhaps too voluminous for the average medical student, but the volumes may be purchased separately. Volume 2, which covers the respiratory system and heart for example, might be the most pertinent volume for the medical student. The author does an admirable job in covering a vast amount of material in a terse, concise manner. The use of a technique

Falx "calcification"--does this exist?

In discussing mineralization of the falx cerebri many radiology textbooks use the term calcification and make no mention of ossification. A retrospective study of 18 consecutive autopsy cases, in which skull radiographs had revealed mineralization of the falx, was undertaken. These areas of mineralization were excised and submitted for histological evaluation. The density seen on the skull radiograph consisted of membranous bone complete with bone marrow elements in all cases. Two cases had metastatic deposits in the ossified falx and one case showed leukemic infiltration. Some aspects of the pathogenetic mechanisms involved in calcification of the falx are discussed.

The lore and the lure o' the lamina dura.

Contrary to statements in some textbooks of radiology, the lamina dura is not an infallible diagnostic sign of hyperparathyroidism. It is a cribriform plate which lines the sockets of teeth, and it responds to the everyday forces transmitted through the teeth to the bone, thus undergoing hyper- and hypocalcification. After extraction of the tooth, it disappears. In several systemic diseases which result in structural changes of the jaws the lamina dura may also change, but disappearance of the lamina dura in the absence of any changes in the remainder of the alveolar bone seldom, if ever, occurs as a result of systemic disease alone.

Paediatrische Radiologie: Stützgewebe-Zentralnervensystem-Syndrome, Vol. I, by Franz Schmid. Berlin/Heidelberg/New York: Springer-Verlag, 1972, 504 pp., $78.70

Only the first volume of this projected two-volume textbook of pediatric radiology is available for review. Included in the first volume is a discussion of bones and soft tissues, the central nervous system, and 100 pages of syndromes in brief tabulated form. This is a handsome book written in German with 451 excellent illustrations. Few of the 16 contributing authors are well known in this country and it would seem that few are full-time pediatric radiologists.

On the nature of the mid-oseophageal diverticulum.

Mid-oesophageal diverticula, according to most textbooks of radiology, have been considered as pulsion or traction diverticula, pulsion due to a weakness in the wall, and traction associated with fibrosis between the oesophagus and adjacent structures. The traction diverticulum is usually considered to be secondary to tuberculous lymphadenitis, affecting nodes in the carinal or sub-carinal regions. One text-book suggests that if an abscess forms, it may weaken the oesophageal wall, and lead to the development of a pulsion as well as a traction diverticulum.

Interpretação radiológica nas alterações do aparelho digestivo nas espécies canina e felina

To examine the digestive system any radiologist must establish a total or regional sequence of work as could be seen in veterinary and human radiology textbooks. With our plan we examined 1.044 animals. The results are presented in 4 tables and illustrated with 17 figures. As the organs and the animals move we chose the least time possible to take the radiografies of the digestive system. We always began the examination with a simple radiografy, in special cases we used special procedures. Studying the abdominal organs we prefered the panoramic radiografies. In many diseases the functional state of the system could be established using the fluoroscopy. The radiografies with contrast, were used as special procedures. For oesophagus, stomach and duodenum we prefered the barium suspensions; for the intestines, gaseous solutions. For colon and rectum radiografies in some cases we used air and in others the double contrast with barium and air.

Textbook of Radiology

An up-to-date and comprehensive single volume textbook of radiology for the advanced trainee in radiology is the avowed editorial goal of the textbook written by 18 eminent British radiologists, and ably edited by Sutton and Grainger. In their formidable task they have succeeded beyond expectations and have produced a classic text that should be owned and read by every radiologist, whether trainee or senior consultant. The book is divided into the traditional anatomic areas of chest; bones and joints; cardiovascular system; urogenital system; central nervous system and ear, nose, and throat; eye; teeth; and soft tissues. The illustrations are numerous, of unusually high quality, and reproduced in their original black and white relationships (ie, without reversal). The book is written with a clarity of style and lucidity that makes for easy, pleasant reading. However, a book of this size deserves a sturdier binding. Mine fell apart after only a few

Book reviewAlimentary Tract Roentgenology. Vols. I and II. Edited by MargulisA. R. and BurhenneH. J., pp. xiv + 1203, 1414 illus., 1967 (London, Henry Kimpton), £29 5s.

Nearly 50 well-known American and European radiologists have contributed towards this two-volume text-book of radiology of the alimentary tract which now becomes the most authoritative and up-to-date postgraduate text book on this subject. The individual authors write on topics which have interested them for many years and on which most have already made worth-while original contributions over the years.

Clinodactyly, camptodactyly, Kirner's deformity, and other crooked fingers.

Curvature of the fingers is fairly common. While it is frequently seen without associated abnormality, it has been noted in conjunction with other pathological conditions often enough that its presence should alert the physician to their possibility. Since the lesion is usually asymptomatic, it is mentioned only briefly in radiologic textbooks. A book on congenital hand anomalies (2) shows crooked fingers in a variety of hand anomalies, but mentions no associated abnormalities. The purpose of this communication is to describe the various types of curved fingers and the conditions with which they are related, as well as the significant associated findings which may aid in a specific diagnosis. The study is based on a review of clinical material from the Henry Ford Hospital in Detroit and the University Hospital in Ann Arbor, as well as a review of the literature. The presence of curved fingers has been appreciated in the medical literature for many years. In an article on mongolism, Smith in 1896 (68) published the first roentgenogram illustrating clinodactyly. We1ch (72) quotes Tamplin who in 1846 described camptodactyly as an entity distinct from Dupuytren's contracture. Clinodactyly and camptodactyly were noted by some of the great masters and depicted in their art. Bruno (7) shows illustrations of camptodactyly by Botticelli and da Vinci. The presently used terminology for crooked fingers was defined between 1910 and 1930 (26,27,54). There has been much confusion in the use of the terms clinodactyly and camp-todactyly. Some authors use them contrary to their common usage and may show an illustration of camptodactyly while labeling it clinodactyly (43). Others use the terms interchangeably. Dutta (11) traces the historical background of the usage of these terms. The following terminology will be used in this text. Terminology Clinodactyly (Gr. klinein to bend + daktylos finger) (11, 28) refers to a curvature of a finger in a mediolateral plane. It may be radial or ulnar in direction and may involve any finger. It usually refers to a radial deviation of the fifth finger at the distal interphalangeal joint and is most often associated with a short middle phalanx which is shorter on its radial than ulnar side (Fig. 1). Some authors (27) use the term clinodactyly in reference to the fifth finger only. In this paper the term will be used in its more general sense. When the fifth finger is referred to, it will be called clinodactyly 5. Camptodactyly (1, 8, 26, 67, 70, 72) (Gr. kamptos bent + daktylos finger) denotes a permanent flexion of one or more of the fingers. The deformity is located at the proximal interphalangeal joint and also usually involves the fifth finger (Fig. 2). Its cause is not known. The condition is probably related to a fascial abnormality (8, 70) but may be related to contracture of the flexor digi-torum sublimis (67).

Book reviewTextbook of Radiology. Edited by SuttonD., assisted by GraingerR. G., pp. xi + 1186, 1616 illus, 1969 (Edinburgh, E. & S. Livingstone Ltd.), £15.

The publication of a new and comprehensive textbook of diagnostic radiology designed for consultant radiologists and senior postgraduate students is a rare event. This one is by a group of well-known British radiologists who have each made a special study of their particular subject. The book follows a traditional design. It is divided first into sections on an anatomical basis and then into descriptions of the pathological conditions which affect the individual organs. In addition, in most of the sections there are brief descriptions of some of the common diagnostic problems met with in radiological practice. The style throughout is clear and simple. The chapters on the chest, myelography and pneumography are particularly lucid. The illustrations are good, although some are a little small.

Experimental Demonstration of the Influence of Bone on Dose Distribution in Radiotherapy

In the practice of radiotherapy, bones within the irradiated field are in many situations a real problem in treatment planning. Roentgenologists and radiotherapists know that bone absorbs more radiation than does muscle or fat. Textbooks of radiology explain why and how and give the classical graph concerning the relation between photon energy and the amount of absorption. The implications for the practice of radiology are well known. For radiation therapy it means that high-energy radiations are indicated for tumors lying behind bone (e.g., intracranial and pelvic tissues). Review of the Literature Many authors have studied the attenuation of x and gamma rays by bone. Quimby (25) was the first to obtain measurements in cadavers, thereby demonstrating the effect of radiation on bone. In practically all subsequent studies, many limitations to the validity of the results stem from the use of improper phantom material. Theoretical studies by Spiers (28) were based on a bone density of 1.85 g/ cc which he ver...

ROENTGENOGRAPHIC VISUALIZATION AND MEASUREMENT OF SKIN THICKNESS AND ITS DIAGNOSTIC APPLICATION IN ACROMEGALY.

Radiographic examination of the skin has attracted little attention. In standard textbooks of radiology, the chapters on soft-tissue radiography are mainly concerned with fat, muscle, and calcification. Such lack of interest is at least partly due to easy access to the skin by established dermatologie methods. Nevertheless, the estimation of its thickness by palpation is understandably inaccurate, and in the available literature no radiographic technic of measurement has been described. Such a method would provide a simple, rapid, painless, and inexpensive means of measuring skin thickness and would enable accurate studies of changes as they relate to sex, aging, complexion, exposure to sunlight, and perhaps certain morbid conditions. The purpose of this paper is to describe some relatively simple methods for visualization and accurate measurement of skin thickness and to give some preliminary results on their application. Theoretical Development And Methods The epidermis and corium have approximately the same roentgen absorption, and together they appear in the roentgenogram as a zone of decreased photographic density (hereafter referred to as “skin”), delineated internally by the subcutaneous fat. Skin thickness varies considerably in different parts of the body, and the site of observation should therefore be strictly standardized. In this work, the radial aspect of the right forearm was chosen. Since the epidermal thickness of the forearm measures only about 40 to 80 microns (5), the roentgenographic method will largely determine the thickness of the corium layer. Inadequate visualization of the skin in standard roentgenograms seems to be due to: (a) the marked difference in roentgen absorption between the fat and the air on each side of the skin and (b) the rounded outline of the skin surface resulting in a photographic density gradient near the surfaces tangential to the roentgen beam. Roentgen absorption in various tissue layers of an extremity surrounded by air is schematically indicated in Figure 1A. The calculated absorption curve (a) shows that the darker appearance on film of the zone of subcutaneous fat is largely an optical illusion, mainly due to a small difference in roentgen absorption in a narrow zone at the skin-fat margin (S-F on the magnified portion of the absorption curve in the insert of Fig. 1A), but to a certain extent also caused by a contrast effect of the lighter muscle density on the other side of the subcutaneous fat. Densitometrie readings (d), indicated by A, S, F, and M in the same graph to designate photographic densities of air, skin, fat, and muscle, respectively, closely conformed to the calculated absorption curve, thus proving the existence of lower photographic density in the central zone of subcutaneous fat than in the skin, in the 40 to 45 kvp range used in this technic. In the same diagram the principal effects of two different roentgen exposures on blackening of the roentgen film are shown.

The Electrocardiogram and Chest X-Ray in Diseases of the Heart

This volume is not a conventional textbook of electrocardiography or chest radiology—it is a long-awaited demonstration of the value of interpreting electrocardiograms and chest x-rays in relation to each other and to all other available clinical data. The introductory chapters describe the normal electrocardiogram and chest x-ray and the variations produced by the physiological factors of age, habitus, and respiration. The format of the remainder of the book is similar to most texts of cardiology in that the various etiological types of heart disease are discussed in turn. The didactic presentation of each subject is brief and most of the book consists of 119 carefully selected illustrative case histories. Every common cardiac lesion and many rare ones are represented in the series. An excellently reproduced teleoroentgenogram and electrocardiogram accompany each clinical presentation. After these records have been described and interpreted, an attempt is made to integrate all the findings into

POPLITEAL ANEURYSM WITH OSTEOCHONDROMA OF THE FEMUR.

This paper might have been more accurately entitled "An Unusual Complication of the Twist," for it was shortly after doing "the twist" that the patient began to complain of pain in the popliteal fossa. Arterial aneurysms of the lower extremity occur infrequently. Mills, at the Mayo Clinic, reported an incidence of only 3.5% in 396 cases of aneurysms.¹Even so, the popliteal artery is the vessel most commonly the site of peripheral aneurysm formation.²The commonest etiologic factor in such aneurysms is arteriosclerosis.³In 100 cases reviewed by Gifford, Hines, and Janes,⁴32 cases were associated with arteriosclerosis, 3 with syphilis, 1 with mycotic infection, and 1 with trauma. No case of popliteal aneurysm associated with osteochondroma or exostosis of the femur was reported by this group of investigators. Brailsford,⁵in his radiology textbook, makes references to a case; however, a detailed case report does

Giant congenital calyceal diverticulum visualised by retrograde pneumopyelography.

Calyceal diverticulum, also called calycine diverticulum, calycine, calyceal or pyelogenic cyst is an entity described in most radiological text-books. According to Schinz, Baensch, Friedel and Uehlinger (1954), it is a condition encountered fairly frequently. Shanks and Kerley (1958) divide such cases into congenital and acquired types. In 6,000 intravenous urographies performed during the last five years in our department, five cases of calyceal diverticulum, two of them with stones, were diagnosed. The following case is of interest because of the unusual size of the diverticulum, and the rarely-used method of visualisation of the upper urinary tract.