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Hippocampal sclerosis without visually detectable hippocampal MRI abnormalities: automated subfield volumetric
Hiromi Masaki1, Keita Watanabe2,3, Shingo Kakeda1,4
1Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
Japanese Journal of Radiology
|July 13, 2020
Summary
Hippocampal sclerosis (HS) can be difficult to detect on MRI. This study found that CA3 subfield volume is a more accurate indicator for diagnosing visually undetectable HS than the entire hippocampus.
Area of Science:
- Neuroimaging
- Neuropathology
- Quantitative MRI
Background:
- Hippocampal sclerosis (HS) is a common cause of epilepsy.
- Standard MRI may not detect HS in all cases, necessitating advanced analysis.
- Accurate diagnosis of HS is crucial for effective treatment.
Purpose of the Study:
- To investigate hippocampal subfield volumes in patients with HS lacking visible MRI abnormalities.
- To assess the diagnostic accuracy of hippocampal subfield volumes for detecting HS.
- To compare the diagnostic utility of specific subfields versus the entire hippocampus.
Main Methods:
- Compared hippocampal subfield volumes using FreeSurfer in 46 unilateral HS patients (26 visually detectable, 20 undetectable) and 54 controls.
- Utilized histopathological diagnosis for HS confirmation.
- Calculated diagnostic accuracy using Area Under the Curve (AUC) from Receiver Operating Characteristic (ROC) analysis.
Main Results:
- Visually detectable HS showed significant atrophy in all hippocampal subfields compared to controls.
- Visually undetectable HS exhibited significant atrophy specifically in the CA3 and hippocampus-amygdala-transition-area.
- CA3 subfield volume yielded a higher AUC (0.719) for diagnosing visually undetectable HS than the entire hippocampal volume (0.614).
Conclusions:
- Visually undetectable HS is characterized by CA3 subfield volume reduction.
- CA3 subfield volume is a more effective biomarker for diagnosing HS when MRI findings are not visually apparent.
- Quantitative MRI analysis of hippocampal subfields improves HS detection accuracy.
