Takahashi S, ed. Neurovascular Imaging: MRI & Microangiography. Springer 2011, 515 pages, 344 illustrations, $219.00. ISBN: 978-1-84882-133-0
“Be sure to grasp the tip of the tail of the horse that is flying in space and time” reads the Japanese inscription in editor Shoki Takahashi’s illustration that introduces his preface. Clinicians must constantly strive to keep abreast of rapidly advancing non-invasive imaging developments that provide increasing neurovascular anatomical detail. Shoki Takahashi has brought together Japanese experts in Neurovascular Imaging: MRI & Microangiography to produce a timely review of neurovascular anatomy and pathology as applicable to rapidly advancing modern MR imaging.
This compact 515-page book is divided into three parts — “Part I: Normal Anatomy of Brain Vessels,” “Part II: Neurovascular Imaging in Pathology,” and “Part III: Anatomy and Imaging of Spinal Vessels.” The chapters in Part I include The main trunks and major arteries of the cerebrum, Basal perforating arteries, Infratentorial arteries, Perforating branches of the anterior communicating artery, Cerebral arterial variations and anomalies diagnosed by MR angiography, and Normal anatomy of intracranial veins. Chapters in Part II include Preoperative visualization of the lenticulostriate arteries associated with Insulo-opercular gliomas, Ischemic complications associated with resection of Opercular gliomas, Imaging and tissue characterization of atherosclerotic carotid plaque using MR imaging, MR imaging of cerebral aneurysms, MR imaging of vascular malformations, Cerebral venous malformations, and Thrombosis of the cerebral veins and dural Sinuses. Part III consists of Vessels of the spine and spinal cord: normal anatomy, MDCT of the artery of Adamkiewicz, Magnetic resonance angiography of the spinal cord blood supply and Magnetic resonance imaging of spinal vascular lesions.
The neurovascular anatomical review is certainly engaging and comprises the majority of the book. The chapter on Basal perforating arteries is excellent, and even the rarely mentioned supraclinoid internal carotid direct perforating arteries are discussed. The unique cadaveric microangiographic figures have exquisite perforator anatomical detail, and the MR angiographic images are of good quality. Although many vascular anatomical and topographical illustrations are reproduced from the literature, their consolidation is particularly helpful.
In contrast to the meticulous cerebral arterial and supratentorial venous anatomical review, there is sparse attention to infratentorial venous drainage. Conspicuously, the important topics of MR imaging in acute large vessel ischemia and intracranial haemorrhage are lacking. “Part II: Neurovascular Imaging in Pathology” comprises rather heterogeneous subject matter, curiously commencing with discussion of opercular gliomas. Although most chapters in Part II are otherwise satisfactory, there are minor deficiencies. The authors suggest that aneurysms associated with arteriovenous malformations (AVMs) are treated similarly to those not associated with AVM’s and that importance of non-invasive detection relates to concurrent management of both the aneurysm and AVM. However, they fail to make the important distinction between intranidal, feeding pedicle and incidental unrelated aneurysms. Patients harbouring intranidal aneurysms more frequently present with intracranial haemorrhage, which often influences the management strategy.
The book also lacks a consistent approach — paraclinoid internal carotid aneurysms are discussed in “Part I: Normal Anatomy of Brain Vessels” and not in the chapter dedicated to cerebral aneurysms. Normal cerebral CT venographic anatomy is incorporated, unlike CT angiography. There are occasional chapters with a case-based style rather than the more structured theme of majority of the book. In addition, treatment options are briefly mentioned in discussion of cerebral vascular malformations but not spinal vascular malformations. Dedication of one of the four chapters in “Part III: Anatomy and Imaging of Spinal Vessels” to MDCT identification of the artery of Adamkiewicz also seems incongruous in a book entitled MRI & Microangiography.
In summary, the neurovascular anatomical review with cadaveric microangiographic figures is impressive. However, Neurovascular Imaging: MRI & Microangiography falls astray in discussion of MR imaging in neurovascular pathology. This book would, thus, be best utilized as a neurovascular anatomical reference as part of a larger neuroradiological library.
