Spine Imaging: Case Review Series, 2nd ed

doi:10.3174/ajnr.A1160

American Journal of Neuroradiology

B. Bowen, A. Rivera, and E. Saraf-Lavi. Baltimore: Mosby; 2008, 392 pages, 415 illustrations, $48.95.

This informative text is a soft-cover, affordable, and well-organized addition to any radiologist's library. It is equally helpful and should be of interest to trainees and lifelong learners alike. As a second edition, it expands the scope of the original with many additional and really interesting cases and has been filled out to a hefty 392 pages.

The format is familiar as part of the popular Case Review Series, with images and questions about the case appearing on the right-hand side, and the answers are only available after turning to the next page. It is possible to cheat, but the page layout and design urge you to just go ahead and make your diagnosis and then turn the page for instant gratification (or not). There are 183 cases in all, and every single case is interesting. The extensive range and variety of cases are amazing, particularly because all of the images seem to have been gathered in the course of routine neuroradiology practice at a single institution, Jackson Memorial Hospital at the University of Miami. This is a really comprehensive collection of pathology, and those of us who are senior members of the American Society of Neuroradiology and who think we may have seen everything will find out that we probably have not. For example, when is the last time you saw a sacral MR imaging scan of a vestigal tail? You will find such a scan in case 183. How about a scan of an intraspinal extradural arachnoid cyst (lymphedema-distichiasis syndrome)? You’ll see a visualization of this particular cyst in case 176. There are also a few images of rare, old-fashioned oddities that are currently evolving from the aging population, such as iophendylate (Pantopaque, for those who remember this as well as the name of the original drummer for the Beatles) mimicking an intradural lipoma (see case 170).

Every case also includes a specific page reference to the popular neuroradiology Requisites series textbook, also the second edition, if any additional reading is needed. An excellent and complete index is included so that an appropriate image of some unusual case with which one might be currently faced in daily practice can be researched. The cases are organized into 3 general chapters, ranging from easiest to hardest, and aptly designated as “Opening Round,” “Fair Game,” and “Challenge.” All imaging modalities are represented in the case reviews from the ever-useful and ubiquitous MR imaging to CT and CT myelography, 3D surface reconstructions, CSF pulsation studies, spinal MR angiography, and even plain radiography. Every case is not studied or presented with images from every technique, however.

I can only make 1 minor criticism in this otherwise worthy text, and that is the responsibility of the publisher. A few of the images are a bit “gray” and may not have been reproduced as clearly as desired. Anatomic and pathologic detail is difficult to appreciate in those few cases. It is always possible that some of these cases are fairly old, and differences in imaging technology are responsible. A little more contrast and sharpness on some of the pages would be nice, but not necessary, because the pathologic features are specifically demonstrated on each of the chosen images.