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Updated: Aug 22, 2026
High-resolution In Vivo Manual Segmentation Protocol for Human Hippocampal Subfields Using 3T Magnetic Resonance Imaging
Published on: November 10, 2015
Qualitative and quantitative imaging of the hippocampus in mesial temporal lobe epilepsy with hippocampal sclerosis
1Department of Neurology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, 49 Herestraat, 3000 Leuven, Belgium. wim.vanpaesschen@uz.kuleuven.be
Abstract:
MR imaging allows the in vivo detection of hippocampal sclerosis (HS) and has been instrumental in the delineation of the syndrome of mesial temporal lobe epilepsy with HS (mTLE-HS). MR features of HS include hippocampal atrophy with an increased T2 signal. Quantitative MR imaging accurately reflects the degree of hippocampal damage.Ictal single photon emission computed tomography (SPECT) in mTLE-HS shows typical perfusion patterns of ipsilateral temporal lobe hyperperfusion, and ipsilateral frontoparietal and contralateral cerebellar hypoperfusion. Interictal 18fluoro-2-deoxyglucose positron emission tomography (PET) shows multiregional hypometabolism, involving predominantly the ipsilateral temporal lobe. 11C-flumazenil PET shows hippocampal decreases in central benzodiazepine receptor density. Future strategies to study the etiology and pathogenesis of HS should include longitudinal MR imaging studies,MR studies in families with epilepsy and febrile seizures, stratification for genetic background, coregistration with SPECT and PET, partial volume correction and statistical parametric mapping analysis of SPECT and PET images.
Insights
Magnetic resonance imaging (MRI) detects hippocampal sclerosis (HS), a key factor in mesial temporal lobe epilepsy (mTLE-HS). Advanced imaging techniques like SPECT and PET reveal characteristic patterns of brain activity and receptor density changes in mTLE-HS.
Area of Science:
- Neurology
- Radiology
- Epileptology
Background:
- Hippocampal sclerosis (HS) is a common cause of mesial temporal lobe epilepsy (mTLE-HS).
- MRI is crucial for diagnosing HS, showing hippocampal atrophy and increased T2 signal.
- Quantitative MRI provides accurate measures of hippocampal damage.
Purpose of the Study:
- To review the role of advanced neuroimaging in understanding mTLE-HS.
- To correlate MR imaging findings with SPECT and PET data.
- To suggest future research directions for HS etiology and pathogenesis.
Main Methods:
- Magnetic Resonance (MR) imaging for detecting HS and hippocampal atrophy.
- Ictal single photon emission computed tomography (SPECT) to assess brain perfusion patterns.
- Interictal 18-fluorodeoxyglucose positron emission tomography (PET) for metabolic activity.
- 11C-flumazenil PET to evaluate benzodiazepine receptor density.
Main Results:
- MR imaging reveals hippocampal atrophy and increased T2 signal in HS.
- SPECT shows ipsilateral temporal lobe hyperperfusion and regional hypoperfusion.
- PET demonstrates multiregional hypometabolism and reduced benzodiazepine receptor density in the hippocampus.
Conclusions:
- Neuroimaging, particularly MRI, SPECT, and PET, is vital for characterizing mTLE-HS.
- These techniques offer insights into the pathophysiology of HS.
- Future research should integrate longitudinal MRI, genetic studies, and advanced analysis of SPECT/PET data.
