British Journal of Radiology (2003) 76, 210
© 2003 British Institute of Radiology
doi:
Applications of sonography in head and neck pathology. Ed by J N Bruneton, pp. 334, 2002 (Springer-Verlag, Heidelberg), £118.00 ISBN 3-540-64598-4
A M K Thomas
In recent years the role of ultrasound in the head and neck has expanded dramatically. When I first learnt ultrasound in the early 1980s it was only possible to identity larger structures on the machines then available. We can now image neck structures in exquisite detail and as each new machine arrives I have to re-evaluate my ideas about normal and abnormal and revise my anatomical knowledge. We can now identify individual nerves of the brachial plexus and see small lymph nodes. It is often difficult to determine the significance of what we are looking at. More recently the advent of power Doppler and other techniques has further enhanced our imaging of neck structures. In my own practice there has been a considerable increase in the number of ultrasound examinations of neck and in particular there has been a sustained increase in the number of fine needle aspirations of thyroid lesions, lymph nodes and neck masses.
Jean-Noel Bruneton has done us all a service and produced an excellent book covering all areas of sonography in the neck. Even though I consider myself experienced in neck ultrasound I have learnt much from reading this book. There is an excellent first chapter on thyroid disease with a useful discussion on ultrasound and palpation guided aspiration of thyroid lesions. Non-significant results with thyroid fine needle aspiration are a problem and this rate can be reduced by repeat aspiration. There is a well-illustrated discussion of thyroid pathology. The chapters on salivary glands and lymph nodes are excellent. The pathological appearances of the salivary glands, which can be confusing, are well discussed. The anatomy of the lymph nodes is covered well and we all should now use the classification of lymph nodes using a system of levels aimed at standardization of neck dissection terminology. Other chapters include the larynx and hypopharynx, the carotid and vertebral arteries and the internal jugular vein. The final chapter is on ultrasound of the neck in children.
I find it difficult to fault this book. There are some techniques described that would not be used commonly in the UK such as the percutaneous ablation of parathyroid lesions by injecting them with 95% ethanol. The illustrations are excellent and there are many full colour Doppler images. There is little duplication of material between the individual chapters, which is a common problem in multi author books. There are good discussions on the value of other imaging techniques. Anyone who performs head and neck ultrasound on a regular basis will benefit from reading this book.
