Abstract
Magnetic resonance imaging (MRI) has been employed as a clinical diagnostic technique in veterinary medicine for nearly 25 years. Yet it has taken until 2009 for a veterinary text on the subject to become available. Therefore, the arrival of this volume has been keenly anticipated.
The principal authors responsible for undertaking this daunting task are a radiologist and neurologist with extensive clinical experience in diagnostic MRI. In the introduction the stated intention of the authors is to provide a practical clinical text. The book is divided into a short section on physics and technical considerations and a much larger clinical section. The clinical section focuses predominantly on neuroimaging (intracranial, spinal and peripheral nerve disease) and the head (non-central nervous system disease). However, shorter sections covering orthopaedic, thoracic and abdominal disease and cancer imaging are included. As this is not a reference text, anyone with a particular interest in MRI would benefit most from a careful reading of this book from cover to cover. By this means the wealth of information, the practical approach and the philosophy intended by the authors are best conveyed.
Clinical MRI represents a huge area to cover and the scope of the text is suitably wide-ranging covering many common conditions. The book is extensively illustrated with more than 1000 images. Although the intention of the authors was not to produce a treatise on MRI physics, I feel the chapter on basic physics could have benefited from inclusion of some explanatory schematics or practical images relating to relevant aspects of tissue relaxation or sequences. Although these features are addressed to some extent elsewhere in the text, it would have been helpful to have illustrated them in this initial chapter. MRI artefacts are well covered, both in the introductory chapter on the subject and throughout the text. In everyday practice we recognise that the close and mutually beneficial relationship between detailed and specific clinical assessments and MRI findings is the cornerstone of accurate MRI interpretation. This theme is emphasised throughout the book and where it is accompanied by comprehensive text, good quality images and detailed legends, it succeeds well. It is especially useful in chapters covering neuroimaging and the correlation between neuroanatomy, pathophysiology and the MRI findings.
There are, however, several disappointments with this book. Despite being lavished with images, the variable quality of the included images represents a weakness. An approach using sequential slices to demonstrate changes on one or more sequences works better for intracranial disease than it does in the chapter on the spinal disease. In the latter chapter, the contiguous images are too small or of unsatisfactory quality. Overall too many images, within the spinal chapter in particular but also throughout the book, could have been better reproduced, appearing as they do grainy and/or pixellated. I felt that the detail included within the image legends, especially in the chapters covering neuroimaging and spinal disease, was frequently too brief. I was keen for a more detailed description of the displayed pathology. For example, a large number of images of intracranial gliomas is included demonstrating a spectrum of changes associated with these tumours, but without any expansion upon the features relevant to each example. Similarly, a number of caudal fossa changes are shown without any comment as to the distinguishing features displayed. Several images are incorrectly arranged or labelled and even the most attentive reader is easily distracted as this is repeated on several occasions. One omission I found disappointing was the repeated reference to the value of gradient echo sequences for the verification of haemorrhage and yet no single example of this has been included, all examples of haemorrhage being limited to spin-echo sequences. In addition, as MRI is a diagnostic modality in which many diseases may have similar features, the book as a practical offering would have benefited from the inclusion of greater reference to the differentiating features of diseases with a similar appearance on MRI or relevant differential diagnoses.
Despite these limitations this book will fill a niche in small animal diagnostic imaging, and as an introductory text it remains comprehensive and still has much to recommend it.