Mukherji SK, consulting ed. Shroff M, guest ed. Pediatric Demyelinating Disease and its Mimics. Elsevier; May 2013. Neuroimaging Clinics of North America; vol. 23; no. 2; pgs. 184-358; $314.
Pediatric Demyelinating Disease and its Mimics is a new and excellent addition to the NICNA collection. Edited and in large part authored/co-authored by Dr. Manohar Shroff, the book contains 11 review articles, which are well written and particularly well illustrated. Starting with the vital chapter, on normal progressive myelination from the premature to newborn to early childhood, the reader is presented with a summary of the key facts and techniques used in judging myelination patterns. This chapter does not burden the reader with unnecessary verbiage but hits the important concepts with beautiful MR images. Following this, we read in the next chapter of the three major divisions of white tracts, namely association tracts (eg, superior longitudinal fasciculus), commissural tracts (eg, corpus callosum), and projection tracts (eg, cortecospinal tracts). In addition, we read about many interesting facts (the chapter actually bears re-reading), including the major tracts, their connections, and their functions. How they co-mingle and change in hue/color is presented herein. Strangely, a couple of images (for example, Figure 11) are described as color FA, but they are in fact grayscales. Because of this, the reader loses a bit of the impact of seeing the SLF or the ILF as the authors had presumably wished.
Three chapter are devoted to pediatric multiple sclerosis (image acquisition, clinicopathology correlations) and advanced MS imaging, and one to ADEM. In the latter chapter, there are the consensus criteria for ADEM along with the multiple and varying presentations and appearances of ADEM. This is an important chapter because of the often deceiving manner in which this disease presents.
Chapters on transverse myelitis and the mimickers of transverse myelitis cover common territory and re-iterate the long list of diseases that can look like the usual inflammatory TM. Evolving concepts in neuromyelitis optica are nicely explained in the following chapter; particularly well done is an explanation of why lesions are seen predominately in certain locations. Inflammatory vasculitis (angiitis) as a cause of ischemia/infarct and of demyelination is a somewhat longer chapter than the other disease-based chapters, but deservedly so. Nicely arranged side-by-side are the MR images (including DWI) and the angiography, whether DSA or MRA. Anti-NMDA receptor encephalitis, which is a commonly forgotten diagnosis when one sees a temporal lobe lesion, is briefly but adequately discussed and illustrated. Fortunately, this chapter does not burden the reader with excessive pathological and immunopathology details. The accompanying table of differential diagnoses emphasizes how elusive this A (NMDA) RE diagnosis can be.
A separate chapter on mimics of pediatric demyelination keeps the reader tuned in by presenting clinical vignettes; these are a challenge but well worth close study, because in those centers dealing with a significant volume of pediatric neurology, such images and clinical stories often present themselves.
This issue of the NICNA is excellent and provides the reader guidelines for dealing with some of the most confounding problems in pediatric neuroradiology. It should be read by all those in neuroradiology.
