Eur J Nucl Med Mol Imaging (2008) 35:1734–1735 DOI 10.1007/s00259-008-0831-0
BOOK REVIEW
EI Bluth, CB Benson, PW Ralls and MJ Siegel MJ (eds): Ultrasonography in urology—a practical approach to clinical problems (2nd edn.) Thieme Medical Publishers, New York 2008, ISBN: 978-3-13-129132-5 Orlando Catalano & Luigi Mansi
Published online: 29 May 2008 # Springer-Verlag 2008
This essential (164 pages), updated teaching book is based on a popular course taught at the RSNA’s annual meeting in Chicago and is now at the second edition. “Ultrasonography in urology” is part of an editorial line from Thieme Publishers. As a matter of fact, all four editors have also published the 2007 Thieme book “Ultrasound—a practical approach to clinical problems”, sharing the practiceoriented style of the current textbook. The four leading authors and the other 14 contributors are all well-recognised experts in the field of abdominal and extra-abdominal ultrasound. They all come from the main American centres of ultrasound teaching and research. In this book, the approach to the sonographic imaging of the urinary tract is directed to clinical problems. In our opinion, this is the best way to structure a medical text, directly driving the reader to the heart of the problem. The clinical settings include 13 chapters: (1) Flank pain, (2) Renal failure, (3) Hematuria, (5) Acute abdominal trauma, (5) Acute scrotal pain: diagnosing with colour duplex sonography, (6) Erectile dysfunction, (7) Urinary tract infections in children, (8) Right lower quadrant pain: ruling out appendicitis, (9) Hypertension and bruit, (10) Elevated PSA and/or abnormal prostate physical examinations: diagnosing prostate cancer, (11) Intraoperative ultrasound, (12) Leg swelling with pain or oedema and (13) Biopsy, drainage, and percutaneous treatment of a mass. Therefore, this text illustrates not only the urinary tract but also some related conditions, which may simulate a urologic problem, O. Catalano (*) : L. Mansi Naples, Italy e-mail:
[email protected] L. Mansi e-mail:
[email protected]
either from a clinical or from a sonographic point of view. The chapter on right lower quadrant pain is mainly focused on ruling out appendicitis. The chapter on trauma imaging relates to the overall ultrasound approach to abdominal trauma and not directly to urologic trauma; when we image an injured subject, we usually do not know if and where he or she has suffered the consequences of the trauma. There is even a chapter on painful or oedematous swelling of the limbs, which only marginally can be considered a “urologic” topic. Obviously, there has been an editorial line in selecting the arguments. This book is not organised as a comprehensive text, systematically covering all aspects of urinary imaging, organ by organ, but it is focused on the most commonly encountered clinical settings or on those conditions where ultrasound may play a major role. There are some “missing issues”. For example, topics such as “suspected hyperfunctioning adrenal tumour” or “painless scrotal swelling”, or “palpable abdominal mass” are not included, even if these issues are not uncommon in clinical practice and even if sonography plays a key role in some of them. The chapter “hypertension and bruit” is only focused on renal artery stenosis while no room is given to other urologic causes of hypertension such as phaeochromocytoma, Conn syndrome or nephropathies. The overall collection of the chapters sounds a little bit forced. As there are some “missing topics”, there also some unnecessary or at least unfocused chapters. Giving an example, the chapter on intraoperative ultrasound and the one on interventional sonography represent a general illustration of these topics without any special focus on the urinary tract. In addition, we have to say that the various chapters do not follow, as they should to, the same structure. Most issues start with an introduction section,
Eur J Nucl Med Mol Imaging (2008) 35:1734–1735
then continue with three subchapters on differential diagnosis, clinical presentation and diagnostic evaluation (the core of each chapter, frequently considering not only ultrasound but also other imaging modalities and laboratory tests) and finally end with a summary. Nevertheless, not all chapters are structured in this linear way, and consequently, the book content seems a little etherogeneous. This may sometime be considered an obvious consequence when a book is written by many hands. Each chapter is of good or even excellent quality, especially if considered as a stand-alone work. There is a clear description of symptoms and differential diagnosis. In most situations, the ultrasound findings are correlated with other imaging modalities, especially with CT but also with MRI and PET. At the end of every chapter, there is a rich bibliography. There are more than 400 photographs and drawings. Most of the illustrations of every chapter are of excellent quality and printed in a very good shape by the famous printing of Thieme. The most representative chapters are chapter 5 on the acute scrotum and chapter 6 on erectile dysfunction. Chapter 5 first analyses the spectrum of acute scrotal pain causes (not only a question of torsion vs. inflammation!),
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then accurately describes the ultrasound equipment setting and examination technique (with special emphasis on spectral and colour-mode assessment), then describes the normal sonographic findings and finally illustrates the abnormal sonographic findings in a wide spectrum of scrotal disorders. Chapter 6 on erectile dysfunction is even more interesting, since it starts with the description and the related images of six patients with six different clinical scenarios. This chapter continues with accurate paragraphs on epidemiology, anatomy, physiology, classification and diagnostic work-up of all conditions causing an erectile dysfunction (ultrasound and imaging tests other than ultrasound). This is a relevant topic in clinical practice, and not all radiologists and non-radiologists performing ultrasound studies have a full knowledge of all the aspects considered in this chapter. In conclusion, we slightly disagree on how the excellent and updated chapters of this book have been selected and put together. Anyway, we still think that this volume will be a good companion for radiologists, residents, sonographers and referring doctors in their education and in their daily practice. A book to be kept in first line in the libraries but even more in the ultrasound laboratories.