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Abstract

clearly an imaging technique which can display structures exquisitely, both in health and disease. Obviously this makes MRI very useful for medical practice, which relies heavily on structural changes for making a diagnosis. PET on the other hand, measures the capacity of brain tissue to handle certain tracer compounds and calculates from that a specified function. To look for visual contrast between one and another region (which is implied in "imaging") is not the first aim of this method. PET will remain for the foreseeable future a clinical research technique because of the limited number of available PET centres, but may also ultimately (according to Ter-Pogossian) have a further reaching effect on medicine than MRI imaging. Research results are presented in a further six chapters, two concerned with MRI imaging and four using PET. All the authors are leading specialists in their fields and the material is presented expertly and usually in much detail. Inevitably the balance between the several chapters is not ideal. For instance chapter 2, supposed to deal with phosphorus-3 I magnetic resonance imaging, does not really belong in the book as it deals with spectroscopy in rats only and concentrates on the description of many technical details more or less indicating that imaging of P-31 is still a long way off. The third chapter deals with MRI imaging of sodium-23 by Hilal and co-workers. This fascinating technique is clearly described (the text was previously published in a journal elsewhere). However, the authors betray their background by stressing "image contrast" more than the possible functional implications of being able to determine regional brain sodium content. Also it is not made clear how this technique could be exploited to investigate ischaemic brain disease. The bulk of the data at present available about "functional mapping" of human brain in relation to cerebrovascular disease is contained within the last four chapters, presenting the viewpoints of four different PET groups. Jones of the London group summarises the advantages of the method using continuous inhalation of gaseous tracers labelled with oxygen-15, allowing regional measurements of oxygen utilisation combined with cerebral blood flow. Clearly combination of tracers for perfusion measurements and determination of actual energy metabolism has been very fruitful in studying pathophysiology of ischaemic lesions. Pawlik and colleagues from the Cologne group describe thoroughly, diffuse and focal changes of glucose metabolism in a large group of patients with of ischaemic lesions. The ren an ischaemic lesion on other brain are presented admirablI detail. Yamamoto and colleal Montreal group concentrate ( measurements of regional blo gen metabolism, glucose utilis: The abundance of data seems together for the reader who i with the topic. The authors si posing patterns of functional in ischaemic disease, althougl tions remain; such as those c validity of the method of it measurements. The specifii inherent to PET studies of rel of varying functional values ir brain regions to a clinic expressed by a multitude of 1 and symptoms, are beautif strated by this study and courn with. The last chapter by Syrota group is an excellent review odological problems of measu brain pH using PET. This ch strates nicely how much qu specific functions lies at the measurements while images co fact no image is used (or ne paper. The author also con flow, oxygen metabolism and ments and suggests interesting for the finding of local alkalos cerebral infarction. As a bonu of brain protein synthesis mea PET is given, although no me: how to use this in the sti brovascular disease. For whom is this book inte give the neurologist who h interest in brain pathoph cerebrovascular disorders a gi of the present state of the art (p far as PET is concerned), alth erable effort will have to be studying methodological ai aspects. This circumstance v make the book less suitable fc clinical neurologist.