Cerebral radionuclide angiography

This atlas of radionuclide "dynamic" studies of the brain comes at a time when CT scanning has replaced radionuclide studies as the primary means of investigating clinically suspected brain disease. It emphasizes those things done best by radionuclides, such as noninvasive and relatively quantitative evaluation of rapidly changing physiological processes. Providing a brief but sound anatomical, physiological, and technical basis for these studies, the atlas delves into a detailed, well-selected case analysis of common clinical categories of trauma, neoplasms, congenital diseases (limited to a few vascular anomalies), vascular diseases, and computer applications. Careful study of each case is necessary to extract the maximum information. There is a great deal of correlative emphasis with electroencephalography and cerebral angiography. As in any such ambitious undertaking, there are points with which one may disagree. I found the embryology section of value for pointing out, but not remedying, my deficiencies. In a number of cases, as is all too common in our daily practice, we are left hanging without definite proof; in one instance of acute changes in a diabetic, even postmortem examination does not explain the scan findings. The references to aneurysms predate the frequent use of angiography, making this portion of the text obsolete. Although reproductions of the radionuclide studies are excellent, the angiograms suffer by comparison. Almost all of the dynamic studies are vertex views, which require much technical care in proper execution and are rarely used in most institutions, although Dr. Deland's results suggest that more widespread use would make the extra trouble worthwhile. The author's results with this technique in studying vascular disease, demonstrating abnormal perfusion studies in more than 90 % of patients with strokes involving the cerebral cortex, need to be substantiated by other groups. The section on computer applications demonstrates succinctly and understandably the promise of superiority which could be provided by quantitative methods. This is a superb atlas: informative, readable, and complete. All physicians who deal with neurological disease, including the general radiologist and angiographer, should be familiar with this book so that their patients may benefit. It should be in the library of all nuclear medicine specialists who perform cerebral radionuclide angiography.