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Hippocampal T2 hyperintensities on 7 Tesla MRI
Susanne J van Veluw1, Laura E M Wisse, Hugo J Kuijf
1Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
Neuroimage. Clinical
|November 2, 2013
Summary
Hippocampal focal T2 hyperintensities (HT2Hs) are common brain imaging findings. High-resolution MRI and histology reveal two types, likely with different causes, and are unrelated to age.
Area of Science:
- Neuroimaging
- Neuropathology
- Radiology
Background:
- Hippocampal focal T2 hyperintensities (HT2Hs), also known as hippocampal sulcal cavities, are frequently observed on Magnetic Resonance (MR) images.
- The origins and clinical relevance of HT2Hs remain unclear, necessitating further investigation.
- Understanding HT2Hs is crucial for accurate interpretation of brain MRIs and potential diagnostic implications.
Purpose of the Study:
- To characterize hippocampal focal T2 hyperintensities (HT2Hs) using high-resolution 7 Tesla (7T) MR imaging.
- To investigate the MR signal characteristics, prevalence, location, and age relationship of HT2Hs.
- To explore the histological basis of HT2Hs through post-mortem examination.
Main Methods:
- Inclusion of 58 individuals without significant neurological or psychiatric history (mean age 64 ± 8 years).
- Acquisition of 7T MRI scans including T1, T2, and FLAIR sequences for all participants.
- Assessment of HT2H signal characteristics, location, and number by two raters, followed by post-mortem MRI and histopathological analysis of brain slices.
Main Results:
- HT2Hs were detected in 97% of subjects, with a median of 10 per person (range 0-20).
- All HT2Hs were hypointense on T1-weighted images. On FLAIR, 94% were hypointense (located in the vestigial sulcus) and 6% were hyperintense (located in the hippocampal sulcus or gray matter).
- Post-mortem analysis indicated FLAIR-hypointense HT2Hs are likely cerebrospinal fluid-filled cavities, while FLAIR-hyperintense HT2Hs represent microinfarcts.
Conclusions:
- Hippocampal focal T2 hyperintensities are extremely common and not associated with age.
- HT2Hs can be categorized into two distinct types based on FLAIR signal intensity, suggesting different etiologies.
- FLAIR-hypointense HT2Hs are likely related to cerebrospinal fluid spaces, whereas FLAIR-hyperintense HT2Hs may indicate microvascular damage.
