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Ophthalmic Ultrasound: a Diagnostic Atlas

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    Ophthalmic Ultrasound: a Diagnostic Atlas. By Cathy Dibernado, Andrew Schachat, and Sharon Fekrat. Pp 160; £63. Stuttgart: Thieme, 1999. ISBN 3-13108-631-9.

    This book is a diagnostic atlas of ophthalmic A and B mode images. The diagnostic scanning techniques and labelling formats are described with clarity in the opening chapter. The techniques described are based on those of Karl Ossoinig, which have been further refined by Sandra Byrne.

    B-scans are taken using a dedicated eye scanner with a mechanically rocked single transducer producing a sector format image. The probe is coupled to the open eye with methyl cellulose coupling. The dedicated eye scanners are much less sensitive than their more modern whole body counterparts, and often operators work on the open eye to avoid a reduction in sensitivity caused by attenuation of sound as it is transmitted through the eyelid.

    This atlas contains over 400 diagnostic images, three quarters of which are B-scans. This reflects a shift in stress away from the A mode technique. Each chapter concentrates on a different portion of the globe. The resolution and grey scale on images is in general poor but, despite this, the authors illustrate some retinal tears and the diagnoses given in the clear and comprehensive figure legends are correct.

    The book does not cover colour flow mapping or spectral Doppler techniques nowadays used routinely to image blood flow. The authors generally attempt to determine blood flow in tumours by flickering of echoes as seen using A mode techniques.

    I found this atlas to be a clearly presented and, within the limitations mentioned above, well balanced book. I would recommend it to all those using dedicated eye scanners, and to those starting out in ophthalmic ultrasound.

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