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Radiological Imaging of the Small Intestine
  1. A H Freeman

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Springer Verlag are producing an extensive range of books entitled Medical Radiology under the general editorship of Professor AL Baert, and this volume on the small intestine is the latest in the line. Professor NC Gourtsoyiannis is its distinguished editor. This is now a very well established series with topics which vary from organ based (that is, pancreas) to technique based (that is, spiral computed tomograpy (CT)) of the abdomen. As with all Springer publications, the illustrations are outstanding and the more than 800 in this book are no exception.

Imaging of the small intestine remains the last redoubt for the gastrointestinal radiologist due to the remorseless advance of endoscopy from both ends of the alimentary tract; a point noted in the foreword by Professor Baert. Virtual colonoscopy has rekindled some interest but this is strictly a polyp/tumour detection exercise and the more subtle and interesting colonic abnormalities elude it. Study of the small bowel however retains that interest, both because of the myriad of processes which may affect it as well as the fact that it is not so easy to initiate the “ knee jerk” response of biopsy it. It therefore remains more of a deductive radiological process where observations need to be carefully integrated with the clinical state of the patient before a reasoned differential can be given. This coupled with the multitude of imaging techniques, from good old fashioned barium to ultrasound, CT, and magnetic resonance (MR), etc, still means that it provides a diagnostic challenge.

How does Radiological Imaging of the Small Intestine help? The answer is enormously, as it presents an encyclopaedic review of all of the small bowel abnormalities with their attendant investigative techniques. The only problem (and it is one which affects all radiological texts) is the question of whether to go for chapters which reflect technique or for those which reflect pathological conditions. In this case the editor has gone for both and while this results in a superlative volume, there is bound to be some repetition. For example, reference to Crohn’s disease or small bowel tumours will appear both in their own section as well as under CT/MR, etc. However, as all of these chapters are written by different authors with their own experiences, this can prove to be an advantage enabling the reader a “second bite of the cherry”.

Is there competition in the market place and how does this book hold up? The inevitable comparison has to be made to Clinical Imaging of the Small Intestine by Herlinger, Maglinte, and Birnbaum, interestingly also published by Springer. This is the more mature book, now in its second edition, having been originally published in 1989. Its authorship is primarily North American with two European contributors whereas Radiological Imaging is primarily a European work with some distinguished North American contributors. Indeed, two of the editors of Clinical Imaging are authors. Both books go for the same layout—that is, chapters which are technique based followed by those on pathological states. Both are totally comprehensive and although Clinical Imaging is slightly larger (576 pp versus 477 pp) it is less expensive (£164 versus £214 ). This price differential is most likely to be due to the inclusion of 141 beautiful colour illustrations of both endoscopic views and pathology specimens in Radiological Imaging. This is also the most recent publication (2002 versus 1999) and in areas where there is rapid technical change—typically MR imaging—the reader can appreciate the difference. It has to be said that both books fulfil their remit extremely well but your reviewer, if he had to choose, would opt for spending the extra Euros.

Professor Gourtsoyiannis and his team have to be congratulated on producing a superb book that graces the swelling ranks of medical radiology. A must for every radiology department and a continuing source of information for any radiologist with an interest in the gastrointestinal system

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