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<meta name="DC.Title" content="Histologically Confirmed Hippocampal Structural Features Revealed by 3T MR Imaging: Potential to Increase Diagnostic Specificity of Mesial Temporal Sclerosis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2154" />
<meta name="DC.Date" content="2010-10-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: With appropriate selection, temporal lobe epilepsy is potentially curable with surgical intervention achieving seizure freedom in ∼80% of individuals. MR imaging−based identification of MTS remains central to the selection process but currently relies on qualitative visual analysis. We sought to determine if new ultrastructural hippocampal details seen on 3T MR imaging had histopathologic correlates and whether these could serve as a useful tool in MTS identification.

MATERIALS AND METHODS: Patients undergoing selective anterior temporal lobectomy ( n = 5) were scanned using 3T MR imaging preoperatively. En bloc resections were rescanned and subsequently prepared for histopathologic analysis of all hippocampal layers in the CA1–3 regions. Using a newly identified landmark from 3T FSTIR coronal images in 20 patients with histologically confirmed MTS, blinded studies compared ipsilateral and contralateral sides to generate threshold measurements for application in a fast quantitative analysis tool.

RESULTS: Histopathologic analysis and correlation with 3T imaging of en bloc resections identified the low-intensity signal as the stratum lacunosum. MTS was associated with extensive gliosis throughout the CA1–3 regions, with loss of tissue thickness in the stratum pyramidale most pronounced in CA1. Fast quantitative analysis by using the stratum lacunosum as a landmark provided a test that identifies MTS with a SN of 70% and SP of 85%.

CONCLUSIONS: Here we delineated ultrastructural hippocampal details seen on 3T MR imaging in both the in vivo and ex vivo setting, correlating these with histopathologic features consistent with MTS, and provided preliminary data suggesting their utility in the development of a quantitative analysis assessment tool for application in surgical-candidate selection.

CA
:   cornu ammonis
EEG
:   electroencephalography
FLAIR
:   fluid-attenuated inversion recovery
FSTIR
:   fast short tau inversion recovery
GFAP
:   glial fibrillary acidic protein
L
:   left
LFB-HE
:   Luxol fast blue/hematoxylin-eosin
mTLE
:   mesial temporal lobe epilepsy
MTS
:   mesial temporal sclerosis
R
:   right
SN
:   sensitivity
S
:   stratum
SNR
:   signal-to-noise ratio
SP
:   specificity
STIR
:   short tau inversion recovery" />
<meta name="DC.Contributor" content="K.L. Howe" />
<meta name="DC.Contributor" content="D. Dimitri" />
<meta name="DC.Contributor" content="C. Heyn" />
<meta name="DC.Contributor" content="T.-R. Kiehl" />
<meta name="DC.Contributor" content="D. Mikulis" />
<meta name="DC.Contributor" content="T. Valiante" />
<meta name="article:published_time" content="2010-10-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="Histologically Confirmed Hippocampal Structural Features Revealed by 3T MR Imaging: Potential to Increase Diagnostic Specificity of Mesial Temporal Sclerosis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;With appropriate selection, temporal lobe epilepsy is potentially curable with surgical intervention achieving seizure freedom in ∼80% of individuals. MR imaging−based identification of MTS remains central to the selection process but currently relies on qualitative visual analysis. We sought to determine if new ultrastructural hippocampal details seen on 3T MR imaging had histopathologic correlates and whether these could serve as a useful tool in MTS identification.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Patients undergoing selective anterior temporal lobectomy (&lt;i&gt;n&lt;/i&gt; = 5) were scanned using 3T MR imaging preoperatively. En bloc resections were rescanned and subsequently prepared for histopathologic analysis of all hippocampal layers in the CA1–3 regions. Using a newly identified landmark from 3T FSTIR coronal images in 20 patients with histologically confirmed MTS, blinded studies compared ipsilateral and contralateral sides to generate threshold measurements for application in a fast quantitative analysis tool.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Histopathologic analysis and correlation with 3T imaging of en bloc resections identified the low-intensity signal as the stratum lacunosum. MTS was associated with extensive gliosis throughout the CA1–3 regions, with loss of tissue thickness in the stratum pyramidale most pronounced in CA1. Fast quantitative analysis by using the stratum lacunosum as a landmark provided a test that identifies MTS with a SN of 70% and SP of 85%.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Here we delineated ultrastructural hippocampal details seen on 3T MR imaging in both the in vivo and ex vivo setting, correlating these with histopathologic features consistent with MTS, and provided preliminary data suggesting their utility in the development of a quantitative analysis assessment tool for application in surgical-candidate selection.&lt;/p&gt;" />
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<meta name="twitter:title" content="Histologically Confirmed Hippocampal Structural Features Revealed by 3T MR Imaging: Potential to Increase Diagnostic Specificity of Mesial Temporal Sclerosis" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: With appropriate selection, temporal lobe epilepsy is potentially curable with surgical intervention achieving seizure freedom in ∼80% of individuals. MR imaging−based identification of MTS remains central to the selection process but currently relies on qualitative visual analysis. We sought to determine if new ultrastructural hippocampal details seen on 3T MR imaging had histopathologic correlates and whether these could serve as a useful tool in MTS identification.

MATERIALS AND METHODS: Patients undergoing selective anterior temporal lobectomy ( n = 5) were scanned using 3T MR imaging preoperatively. En bloc resections were rescanned and subsequently prepared for histopathologic analysis of all hippocampal layers in the CA1–3 regions. Using a newly identified landmark from 3T FSTIR coronal images in 20 patients with histologically confirmed MTS, blinded studies compared ipsilateral and contralateral sides to generate threshold measurements for application in a fast quantitative analysis tool.

RESULTS: Histopathologic analysis and correlation with 3T imaging of en bloc resections identified the low-intensity signal as the stratum lacunosum. MTS was associated with extensive gliosis throughout the CA1–3 regions, with loss of tissue thickness in the stratum pyramidale most pronounced in CA1. Fast quantitative analysis by using the stratum lacunosum as a landmark provided a test that identifies MTS with a SN of 70% and SP of 85%.

CONCLUSIONS: Here we delineated ultrastructural hippocampal details seen on 3T MR imaging in both the in vivo and ex vivo setting, correlating these with histopathologic features consistent with MTS, and provided preliminary data suggesting their utility in the development of a quantitative analysis assessment tool for application in surgical-candidate selection.

CA
:   cornu ammonis
EEG
:   electroencephalography
FLAIR
:   fluid-attenuated inversion recovery
FSTIR
:   fast short tau inversion recovery
GFAP
:   glial fibrillary acidic protein
L
:   left
LFB-HE
:   Luxol fast blue/hematoxylin-eosin
mTLE
:   mesial temporal lobe epilepsy
MTS
:   mesial temporal sclerosis
R
:   right
SN
:   sensitivity
S
:   stratum
SNR
:   signal-to-noise ratio
SP
:   specificity
STIR
:   short tau inversion recovery" />
<meta name="og-title" property="og:title" content="Histologically Confirmed Hippocampal Structural Features Revealed by 3T MR Imaging: Potential to Increase Diagnostic Specificity of Mesial Temporal Sclerosis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/9/1682" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: With appropriate selection, temporal lobe epilepsy is potentially curable with surgical intervention achieving seizure freedom in ∼80% of individuals. MR imaging−based identification of MTS remains central to the selection process but currently relies on qualitative visual analysis. We sought to determine if new ultrastructural hippocampal details seen on 3T MR imaging had histopathologic correlates and whether these could serve as a useful tool in MTS identification.

MATERIALS AND METHODS: Patients undergoing selective anterior temporal lobectomy ( n = 5) were scanned using 3T MR imaging preoperatively. En bloc resections were rescanned and subsequently prepared for histopathologic analysis of all hippocampal layers in the CA1–3 regions. Using a newly identified landmark from 3T FSTIR coronal images in 20 patients with histologically confirmed MTS, blinded studies compared ipsilateral and contralateral sides to generate threshold measurements for application in a fast quantitative analysis tool.

RESULTS: Histopathologic analysis and correlation with 3T imaging of en bloc resections identified the low-intensity signal as the stratum lacunosum. MTS was associated with extensive gliosis throughout the CA1–3 regions, with loss of tissue thickness in the stratum pyramidale most pronounced in CA1. Fast quantitative analysis by using the stratum lacunosum as a landmark provided a test that identifies MTS with a SN of 70% and SP of 85%.

CONCLUSIONS: Here we delineated ultrastructural hippocampal details seen on 3T MR imaging in both the in vivo and ex vivo setting, correlating these with histopathologic features consistent with MTS, and provided preliminary data suggesting their utility in the development of a quantitative analysis assessment tool for application in surgical-candidate selection.

CA
:   cornu ammonis
EEG
:   electroencephalography
FLAIR
:   fluid-attenuated inversion recovery
FSTIR
:   fast short tau inversion recovery
GFAP
:   glial fibrillary acidic protein
L
:   left
LFB-HE
:   Luxol fast blue/hematoxylin-eosin
mTLE
:   mesial temporal lobe epilepsy
MTS
:   mesial temporal sclerosis
R
:   right
SN
:   sensitivity
S
:   stratum
SNR
:   signal-to-noise ratio
SP
:   specificity
STIR
:   short tau inversion recovery" />
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      <h1 class="highwire-cite-title" id="page-title">Histologically Confirmed Hippocampal Structural Features Revealed by 3T MR Imaging: Potential to Increase Diagnostic Specificity of Mesial Temporal Sclerosis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">K.L. Howe</span>, <span class="highwire-citation-author" data-delta="1">D. Dimitri</span>, <span class="highwire-citation-author" data-delta="2">C. Heyn</span>, <span class="highwire-citation-author" data-delta="3">T.-R. Kiehl</span>, <span class="highwire-citation-author" data-delta="4">D. Mikulis</span> and <span class="highwire-citation-author" data-delta="5">T. Valiante</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1682-1689; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2154 </span></div>
  
  
  
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<p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> With appropriate selection, temporal lobe epilepsy is potentially curable with surgical intervention achieving seizure freedom in ∼80% of individuals. MR imaging−based identification of MTS remains central to the selection process but currently relies on qualitative visual analysis. We sought to determine if new ultrastructural hippocampal details seen on 3T MR imaging had histopathologic correlates and whether these could serve as a useful tool in MTS identification.</p>
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<p id="p-2"><strong>MATERIALS AND METHODS:</strong> Patients undergoing selective anterior temporal lobectomy (<em>n</em> = 5) were scanned using 3T MR imaging preoperatively. En bloc resections were rescanned and subsequently prepared for histopathologic analysis of all hippocampal layers in the CA1–3 regions. Using a newly identified landmark from 3T FSTIR coronal images in 20 patients with histologically confirmed MTS, blinded studies compared ipsilateral and contralateral sides to generate threshold measurements for application in a fast quantitative analysis tool.</p>
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<p id="p-3"><strong>RESULTS:</strong> Histopathologic analysis and correlation with 3T imaging of en bloc resections identified the low-intensity signal as the stratum lacunosum. MTS was associated with extensive gliosis throughout the CA1–3 regions, with loss of tissue thickness in the stratum pyramidale most pronounced in CA1. Fast quantitative analysis by using the stratum lacunosum as a landmark provided a test that identifies MTS with a SN of 70% and SP of 85%.</p>
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<p id="p-4"><strong>CONCLUSIONS:</strong> Here we delineated ultrastructural hippocampal details seen on 3T MR imaging in both the in vivo and ex vivo setting, correlating these with histopathologic features consistent with MTS, and provided preliminary data suggesting their utility in the development of a quantitative analysis assessment tool for application in surgical-candidate selection.</p>
</div></div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">CA<span class="def-item-dt-sep"></span></dt><dd>cornu ammonis<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">EEG<span class="def-item-dt-sep"></span></dt><dd>electroencephalography<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">FLAIR<span class="def-item-dt-sep"></span></dt><dd>fluid-attenuated inversion recovery<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">FSTIR<span class="def-item-dt-sep"></span></dt><dd>fast short tau inversion recovery<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">GFAP<span class="def-item-dt-sep"></span></dt><dd>glial fibrillary acidic protein<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">L<span class="def-item-dt-sep"></span></dt><dd>left<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">LFB-HE<span class="def-item-dt-sep"></span></dt><dd>Luxol fast blue/hematoxylin-eosin<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">mTLE<span class="def-item-dt-sep"></span></dt><dd>mesial temporal lobe epilepsy<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">MTS<span class="def-item-dt-sep"></span></dt><dd>mesial temporal sclerosis<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">R<span class="def-item-dt-sep"></span></dt><dd>right<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">SN<span class="def-item-dt-sep"></span></dt><dd>sensitivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">S<span class="def-item-dt-sep"></span></dt><dd>stratum<span class="def-item-dd-sep"></span></dd><dt id="def-item-13">SNR<span class="def-item-dt-sep"></span></dt><dd>signal-to-noise ratio<span class="def-item-dd-sep"></span></dd><dt id="def-item-14">SP<span class="def-item-dt-sep"></span></dt><dd>specificity<span class="def-item-dd-sep"></span></dd><dt id="def-item-15">STIR<span class="def-item-dt-sep"></span></dt><dd>short tau inversion recovery</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/9/1682.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 31</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 9 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Oct 2010 </div></div>
      
      
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      <div class="highwire-cite-title">Histologically Confirmed Hippocampal Structural Features Revealed by 3T MR Imaging: Potential to Increase Diagnostic Specificity of Mesial Temporal Sclerosis</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">K.L.</span> <span class="nlm-surname">Howe</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Dimitri</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Heyn</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">T.-R.</span> <span class="nlm-surname">Kiehl</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Mikulis</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Valiante</span></span></span></div>
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">K.L.</span> <span class="nlm-surname">Howe</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Dimitri</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Heyn</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">T.-R.</span> <span class="nlm-surname">Kiehl</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Mikulis</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Valiante</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1682-1689; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2154 </span></div>
  
  
  
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