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Mayo Clinic Gastrointestinal Imaging Review

Emory University School of Medicine Atlanta, GA 30322

By C. Daniel Johnson and Grant D. Schmit. Rochester, MN: Mayo Clinic Scientific Press, 752 pp., 2005. $99.95 (ISBN: 0-8493-9795-2)

Authors C. Daniel Johnson and Grant D. Schmit have undertaken an ambitious project—to provide an atlas of nearly the entirety of gastrointestinal imaging in a single, concise, and affordable volume. And they have largely succeeded. Mayo Clinic Gastrointestinal Imaging Review is organized in sections by organ system (esophagus, stomach, bile ducts and gallbladder, pancreas, and so on) and within each section by the types of processes affecting that organ system. For example, in the chapter on the esophagus, the subsections include inflammatory and ulcerative diseases, strictures, masses and filling defects (further divided into benign, malignant, and nonneoplastic processes), diverticula, and miscellaneous. Included in the section on diverticula are examples of lateral pharyngeal pouches, Zenker's diverticulum, Killian-Jamieson diverticulum, mid esophageal traction diverticulum, epiphrenic pulsion diverticulum, and intramural esophageal pseudodiverticulosis—the full range of diverticular disease affecting the esophagus.

The authors use a standard format for each case, allowing the reader to first look at the image or images, then look at the imaging findings, and finally at the differential diagnosis before looking at the actual diagnosis and discussion. In this way, the reader is challenged to come to a conclusion about the case before reading the authors' take on the findings and diagnosis. A resident can use the cases for self testing and as a way of preparing for case conferences, the American College of Radiology in-training examination, or the radiology boards. A practicing physician can also use the text to stay sharp in the field of diagnostic imaging of the gastrointestinal tract.

Alternatively, the reader can use the subject index to find discussion and examples of particular processes or the case index to find images of a specific disease, perhaps to compare and contrast with an actual case in practice. Flipping through a particular section to match the imaging findings of a current case with one included would be another valuable way to use this book and provide a differential diagnosis for a particular imaging finding. The authors also provide differential diagnosis tables as well as summary tables that synthesize material and give key diagnostic criteria for differentiation of the various entities illustrated. Case numbers are also included in the summary tables. Each chapter contains line drawings of the various entities, which further allow the reader to compare pathology.

A distinct advantage of this book is the myriad fluoroscopic images included, most of which are of excellent quality. In the era of a reliance on CT and other higher-tech imaging, radiologists in training are not exposed to as much basic imaging as they are expected to know. The section on differentiation of disease affecting the small bowel is especially well handled using fluoroscopy because the authors take a thorough approach to the diagnosis of small-bowel pathology by fold morphology. However, this is not to say that CT is underused; in fact, there is extensive use of CT-based cases. Sonography, MRI, and nuclear medicine are used to a lesser degree but appropriately so realizing this book is not an atlas of all imaging of all gastrointestinal disease but rather an atlas of the most common imaging manifestations of the most common diseases.

In all, 763 cases are presented, usually as one or two parts. As noted, the fluoroscopic images are generally of excellent quality. Only a few of the CT cases are examples from older-generation scanners that, although they show the imaging findings, do not do so with as much crispness or contrast as examples from the newer scanners. Most of the sonographic images are of good-to-excellent quality, but a few have not reproduced well. However, despite this, the images do show the findings. MRI cases are generally of good quality, but if the reader is looking for extensive use of MRI examples, this is not the volume to buy. Included are approximately four bowel, 17 liver, 14 bile duct or gallbladder, six pancreas, and two spleen cases that make use of MRI. However, this likely reflects the current pattern of use of MRI in elucidating diseases of the gastrointestinal tract and, in future additions of this publication, one might expect more cases including MRI. One complaint I have of a case using MRI is the lack of fat-suppressed or out-of-phase imaging to illustrate intralesional fat in one particular case of focal hepatocellular carcinoma. The inclusion of simply a lesion of high signal intensity on T1- and T2-weighted imaging alone does not make the necessary imaging point. But this is a rare instance of a case that is not appropriately displayed.

Not included in this volume are any suggestions for further reading or, indeed, any references. In the preface, the authors actually concede that they intended the book as an efficient review and did not aim for the consumer looking for an exhaustive textbook. Overall, Mayo Clinic Gastrointestinal Imaging Review is a good teaching atlas providing the reader with a thorough overview of the many common, and a few not so common, diseases affecting the gastrointestinal tract using the most appropriate imaging techniques currently available.

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Baumgarten, D. Search for Related Content PubMed Articles by Baumgarten, D. Social Bookmarking                      What's this?