Burgener FA, Herzog C, Meyers SP, et al. Differential Diagnosis in Computed Tomography. 2nd Ed. Thieme 2012, 868 pages, 2146 illustrations, $219.00.
The second edition of Differential Diagnosis in Computed Tomography, written by Drs. Burgener, Herzog, Meyers, Zaunbauer, is an 854-page hardcover text which covers the field of CT imaging. Included are six separate sections: Intracranial Lesions, Head and Neck, Spine, MSK, Thorax, Abdomen and Pelvis. Considering the parts of the book concerned with neurology (which includes a short segment on spine fractures in the MSK section), neuroradiology consumes well over half of this book (480 pages).
In the chapters on intracranial CT, the brain and extra-axial lesions, ventricles and cisterns, meninges and skull, and vascular lesions are discussed. Recognizing that, for most part, MR is the preferred imaging modality for the brain, Dr. Meyers has with some cases integrated CT and MR. At a glance one quickly can appreciate the advantages of one over the other in different clinical settings. The same holds true when discussing spine lesions where it is clearly recognized that, besides trauma, potentially calcified lesions, and purely bony pathology, MR is vastly preferred. With the ratcheting down of imaging because of overall costs, it is worthwhile to consider the pros and cons of these modalities.
It is well recognized that the story changes when speaking of head and neck imaging: the value of CT is unmistakably better in a number of circumstances and, most often, the only imaging needed. Nonetheless, correlative MR/CT should have been more emphasized.
The setup throughout the book is generally uniform, and the bulk of each section and chapter, aside from a couple of pages of introductory material, consists of well designed Tables which categorize and enumerate the diseases, summarize the CT findings, and comments of value concerning the disease entity itself. These tables are, of course, complimented by imaging (predominately but not exclusively CT). The neuro images are well described and appropriately labeled.
If we take the orbit chapter as an example, there would have been vast improvement in the material had the authors (Drs. Zaunbauer and Burgener) included some MR imaging and if they would have used more up-to-date, higher quality CT images. There are many advantages and important additional information gained by using MR in the orbit for ON lesions and space occupying mass. That chapter is a disappointment because, again, a reader wants to know the pluses and minuses of different imaging modalities. The authors needed, for example, to have shown the CT and MR of an optic neuritis or of optic nerve ischemia in order to demonstrate the clear-cut benefit of MR. Other examples of this could be mentioned in this review, such as in lymphomas or abscesses, and in fact in other areas of head and neck imaging.
This book is packed with information, but for the neuroradiologist the material is considered uneven—good in the brain and spine but less so in chapters in head and neck. If, in the future, the authors intend to publish a third edition of this book, they should tightly compare CT and MR. That would make for a more worthwhile publication.
In summary, this book is dated for neuroimaging. It does not address (for the most part) images with which we most commonly deal. Many other works in neuroradiology surpass this book, and therefore, anyone looking for a publication in the brain, spine, and head/neck, other purchases would be wiser.
