Book Review
Thoracic Imaging: Pulmonary and Cardiovascular Radiology, 2nd ed. By W. Richard Webb and Charles R. Higgins.
Philadelphia, PA: Lippincott Williams & Wilkins, 928 pp., 2011. $229 hardcover (ISBN: 978-1605479767)
D
rs. Webb and Higgins have up-
dated their single-volume com-
prehensive text of pulmonary
and cardiac imaging. It is well
suited to anyone with an interest in the sub-
ject and, again, an excellent reference for ra-
diology residents and fellows. The book has
grown by one chapter but uses the same topi-
cal organization. Immediately apparent are
the high-quality illustrations, many entirely
new or more crisply defined replacements of
the older images. New graphics, headings,
charts, and pathologic specimen photographs
are now printed in color; the addition of new
American Journal of Roentgenology 2011.197:W542-W542.
surface display images makes this a very at-
tractive volume.
The book consists of 38 chapters; 29 are
devoted to pulmonary topics and the remain-
der to CT and MRI of the heart. Within ev-
ery chapter, the salient features of each topic
are summarized in tables, providing a quick
reference and review. The text incorporates
radiography, CT, MRI, nuclear imaging,
and angiography to fully characterize each
abnormality and give the reader a broader
understanding of the pathology from a mul-
timodality radiologic viewpoint.
The first chapter on congenital abnormali-
ties makes good use of the multimodality for-
mat, followed by a discussion on the various
appearances of atelectasis and consolidation.
Lung cancer is then covered, followed by
chapters on the manifestations of metastatic
tumor, lymphoma, and lymphoproliferative
disease. Normal anatomy pertaining to the
pulmonary hila and mediastinum on postero-
anterior and lateral radiography and CT is
then examined in detail, with generous use of
clearly labeled images and figures. The chap-
ter on the normal mediastinum dedicates a
page to each normal mediastinal line, stripe,
AJR 2011; 197:W542 0361–803X/11/1973–W542 © American Roentgen Ray Society
W542 AJR:197, September 2011
and space using coronal reconstructions and
tables to clarify each example. The abnormal
mediastinum is then covered and includes
charts and differential diagnoses; this chap-
ter is further augmented with illustrations of
lymph node enlargement and the numeric sta-
tions assigned by the major lung cancer stag-
ing groups. In the next chapter on solitary and
multiple nodules, updated topics include the
addition of the Fleischner Society and Ameri-
can College of Chest Physicians recommen-
dations for imaging of pulmonary nodules.
The text next addresses specific topics such
as: the radiographic and high-resolution CT
assessment of diffuse infiltrative lung disease,
pulmonary edema, acute respiratory distress
syndrome-ICU radiology, infections, and
pneumoconioses followed by airways, pleu-
ral, and vascular diseases, to name a few. The
term “acute lung injury” is introduced in the
discussion of increased permeability edema
with diffuse alveolar damage. The H1N1
(swine flu) influenza virus is now included in
the updated chapter on infection. The chap-
ter on pulmonary thromboembolic disease
includes a discussion of lower extremity so-
nography and pulmonary MRI–MR angiog-
raphy in addition to radiography, scintigraphy,
pulmonary angiography, and PET. The use
of pulmonary CT for risk stratification in pa-
tients with acute pulmonary embolism is dis-
cussed. There is a new section on the use of
pulmonary embolism CT during pregnancy
with recommendations for the radiologic
workup of pulmonary embolism, including a
discussion of PECT versus ventilation-perfu-
sion scanning. Strategies to reduce the mater-
nal radiation dose from CT are also discussed.
In the chapter on MDCT and MRI of the tho-
racic aorta, there is also a new discussion of
aortic stent-grafts and endoleaks.
The cardiac section has similarly been up-
dated with new images, expanded topics, and
illustrations. It is modestly enlarged by split-
ting the prior single myocardial and pericar-
dial diseases chapter into two chapters.
The cardiovascular section begins with a dis-
cussion of the radiographic findings in acquired
and congenital heart diseases. The reader is
first provided with an organized approach to
evaluating the chest radiograph, keeping to the
format of providing tables describing the salient
radiographic features. MR findings in congeni-
tal and ischemic heart disease, valvular dis-
eases, and myocardial and pericardial disease
follow. Cardiac and pericardial masses, CT and
MRI of ischemic heart disease, coronary cal-
cium screening, and coronary angiography us-
ing MDCT and electron-beam CT complete the
book. Changes in this second edition include a
more detailed discussion of myocardial injury,
and, in the discussion of cardiac CT, the previ-
ous emphasis on electron-beam CT has shifted
to MDCT. There is a timely new discussion on
radiation reduction techniques for CT angiogra-
phy of the heart. The cardiac section ends with
a discussion of new applications of myocardial
perfusion and viability.
The authors have again successfully ful-
filled their goal of producing an inclusive,
high-quality, single-volume text. This second
edition of Thoracic Imaging: Pulmonary and
Cardiovascular Radiology will be particular-
ly useful for the radiology resident looking for
a one-stop textbook of pulmonary and cardio-
vascular imaging and would be an excellent
addition to the departmental library.
Howard I. Jolles
Mayo Clinic Florida
Jacksonville, FL
DOI:10.2214/AJR.11.6715
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