Direct Diagnosis in Radiology: Gastrointestinal Imaging is a good source of information for medical professionals who gravitate toward review books written in bullet point format. A large amount of information is contained within the text of this very compact book. Divided into 9 chapters (liver, gallbladder and biliary tract, pancreas, gastrointestinal tract [general], esophagus, stomach and duodenum, small bowel, colon and anus, and abdominal cavity), this book contains 256 images including computed tomography, magnetic resonance (MR) imaging, ultrasound, barium studies, and occasionally endoscopic retrograde cholangiopancreatography and angiography.
The number of conditions discussed per chapter is quite variable. Twenty different topics are discussed in the pancreas chapter (for example, pancreas divisum, pancreatitis, adenocarcinoma, and cystic fibrosis), whereas only two topics (gastric carcinoma and duodenal diverticulum) are discussed in the stomach and duodenum chapter. An average of one or two examples are shown for each condition, and topics covered in the text for each condition include a definition of the condition (epidemiology, etiology, pathophysiology, and pathogenesis), imaging signs (modality of choice and a description of the findings on pertinent modalities), clinical aspects (typical presentation, treatment options, course and prognosis, and a section entitled “what does the clinician want to know?”), differential diagnosis (in tabular form with “pearls” for each diagnosis), tips and pitfalls related to imaging, and selected literature. The publishers claim that the book contains cases one is likely to see in a typical working day, and, generally, this claim is true; of the 70 topics covered, only about 10% are rare (for example, retrorectal cystic hamartoma or double gallbladder).
An overall strength of this book is the large quantity of information contained in the text of this compact volume. The reader can rapidly gain “radiology-centric” information about a given condition. This book may be best used if one wants to brush up on “factoids” related to a given condition. A 6.5-page index aids in this endeavor, with illustrations noted by italicized page numbers.
A limitation of this book is that many of the illustrations are not annotated with arrows, although each is fully described in accompanying legends. Although the pathologic finding is obvious in most of the cases, this lack of annotations may make this book a challenging read for a medical student or first-year radiology resident.
For those preparing for oral board examinations, the layout of this text is not designed so that the cases can be taken as unknowns. However, the text is a concise source for a large volume of information related to a given condition. This volume may be useful as a text borrowed from a radiology residency library for those preparing for written or oral boards or while one is on a gastrointestinal radiology service.
In terms of imaging modalities featured, computed tomography images are provided most frequently, followed by MR images. This book may be helpful for those residents who have little exposure to MR during residency and would like to see more MR images. The vast majority of the MR images are labeled as T1 or T2 and as pre- or post-contrast. However, for those with no MR exposure during residency, the lack of image annotations may again prove frustrating. In addition, MR physics is not a focus in this volume, so that optimization of MR imaging is not included. Because only approximately 19 barium images are shown, this volume does not provide an exhaustive review of barium-based imaging.
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