Hippocampal sclerosis without visually detectable hippocampal MRI abnormalities: automated subfield volumetric analysis
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ORIGINAL ARTICLE
Hippocampal sclerosis without visually detectable hippocampal MRI abnormalities: automated subfield volumetric analysis Hiromi Masaki1 · Keita Watanabe1,7 · Shingo Kakeda1,6 · Satoru Ide1 · Kohichiro Sugimoto1 · Issei Ueda1 · Toshihiko Hamamura1 · Sachi Hisanaga1 · Tomoko Toyota2 · Naoki Akamatsu2,5 · Shohei Shimajiri3 · Junkoh Yamamoto4 · Shigeru Nishizawa4 · Hiroaki Adachi2 · Yukunori Korogi1 Received: 3 March 2020 / Accepted: 19 June 2020 © Japan Radiological Society 2020
Abstract Purpose This study aims to investigate hippocampal subfield volumes in patients with hippocampal sclerosis (HS) without visually detectable MRI abnormalities and to determine the diagnostic accuracy using hippocampal subfield volumes. Materials and methods We examined 46 patients with unilateral HS who had a histopathological diagnosis, and 54 controls. The patients were divided into two groups; visually detectable HS (n = 26) and undetectable HS (n = 20) on MRI. The volumes of hippocampal subfield using FreeSurfer were compared among the three groups. Diagnostic accuracy was calculated as the AUC of ROC using cutoff values for each individual subfield. Results Compared with the controls, visually detectable HS showed significantly reduced volumes of all the hippocampal subfields and entire hippocampus, whereas visually undetectable HS showed significant atrophy only in the CA3 and hippocampus-amygdala-transition-area. To diagnose visually undetectable HS, the CA3 volumes had AUC of 0.719, which was higher than AUC of 0.614 based on the entire hippocampal volumes. Conclusion Visually undetectable HS demonstrated volume reductions in the CA3. Further, the CA3 volumes was more useful to diagnose visually undetectable HS compared with the entire hippocampal volumes. Keywords Hippocampal sclerosis · Hippocampal subfield · Hippocampus · MRI · Epilepsy
* Keita Watanabe [email protected]‑u.ac.jp 1
Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1‑1 Iseigaoka, Yahatanishi‑ku, Kitakyushu 807‑8555, Japan
Department of Neurology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
2
3
Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
4
Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
5
Department of Neurology, School of Medicine, International University of Health and Welfare, Otawara, Japan
6
Department of Diagnostic Radiology, Hirosaki University Graduate School of Medicine Radiology, Aomori, Japan
7
Open Innovation Institute, Kyoto University, Kyoto, Japan
Abbreviations CA Cornu ammonis GC-DG Granule cell layer of dentate gyrus HS Hippocampal sclerosis HSV Hippocampal subfield volumetry ILEA International league against epilepsy MTLE Mesial temporal lobe epilepsy SD Standard deviation
Introduction Hippocampal sclerosis (HS) is a neuropathological condition characteriz
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