Emergency Radiology—Imaging and Intervention

doi:10.3174/ajnr.A0882

B. Marincek and R.F. Dondelinger, eds. Berlin-Heidelberg, Germany: Springer; 2007, 650 pages, 1000 illustrations, $389.00.

The field of emergency radiology has emerged in the past 12 years into an important subspecialty in radiology. It is important for the emergency radiologist to be well versed in the different imaging modalities and have, as well, more than a passing knowledge of the varied pathologic processes that may be encountered in patients presenting with both traumatic and nontraumatic emergencies. It is now more common for radiologists to be involved, directly or indirectly, with necessary diagnostic and interventional procedures in patients presenting to the trauma center or emergency department. Indeed, the most significant changes in the fields of emergency medicine and surgery have come about because of the tremendous advancements in radiologic imaging that we have witnessed in the past 10 years. The role of multidetector computerized tomography (MDCT) has revolutionized diagnostic imaging and medicine in general.

A new text has emerged that deals with the extensive field of emergency radiology. A large group of specialists from Europe and the United States coauthored this book, which ambitiously covers the imaging and interventional aspects of emergency radiology, appropriately titled Emergency Radiology. Imaging and Intervention. The book is divided into 7 different sections. The first section discusses the role of radiologic imaging in the trauma setting as well as the use of advanced postprocessing techniques in the traumatic and nontraumatic emergency settings. The second section deals with the imaging and interventional techniques of patients with polytrauma, including the imaging and intervention of frequently encountered delayed complications. Each body region with its specific injuries is discussed in its own separate subdivision (ie, head, facial, spinal, and thoracic injuries).

Sections 3, 4, and 5 are devoted to imaging and intervention of neurologic, thoracic, and abdominal nontraumatic emergencies. The sixth section addresses nontraumatic vascular emergencies, and the seventh section is devoted to pediatric emergencies.

The images in the book are of high quality, and the color plates are excellent. The authors demonstrate well the strengths and weaknesses of the various postprocessing techniques such as multiplanar reformations, maximum intensity projections, and volume-rendered images obtained from MDCTs. When tables are used, they are well formulated and easy to understand.

The general flow in each section of this book is diagnostic imaging followed by interventional techniques and treatment options (eg, nontraumatic neuroimaging and neurologic intervention). Overall, the authors do an excellent job in communicating their expertise. Those sections dealing with interventional techniques and neuroradiology are especially well written and informative.

The section on imaging of abdominal and pelvic injuries discusses traumatic injury on an organ-by-organ basis. The grading of splenic and renal injuries is discussed, but the actual grading systems and their definitions are not explained, leaving the reader to look elsewhere for that information. The grading of liver injuries is not mentioned. On the other hand, a grading system for pancreatic injury is defined and discussed.

The book does contain a multitude of spelling errors (eg, “transaction” for “transection”) as well as errors in spacing (eg, “pulmonaryembolism” for “pulmonary embolism”). These types of errors are found throughout the book, which demonstrates inappropriate proofreading. There are errors also in the legends of some of the plates. For example, an MR image shows anterior subluxation of C4 on C5, but the legend actually reads “… anterior subluxation of C2 on C3.” Most of these errors are noted in the section on pelvic fractures in which various anatomic parts are labeled with numbers, but arrows to the relevant anatomy are missing. In 1 plate, the legend refers to a number “5,” which is not present on the image. Despite the aforementioned errors, the book is informative, up to date, and enjoyable.

Emergency Radiology. Imaging and Intervention is an ambitious undertaking by the authors but well worth it. The subject matter is well presented and would be useful to emergency department physicians and radiology residents rotating through a trauma center or emergency radiology department. Those radiologists whose practice does not include the performance of interventional procedures would also benefit from the information in this volume. This reviewer plans to keep a copy available to the residents, fellows, and attending physicians working in the emergency and trauma radiology departments.