Adachi Michito, Kawakatsu Shinobu, Hosoya Takaaki, Otani Koichi, Honma Tsuguo, Shibata Akiko, Sugai Yukio
Department of Radiology, Yamagata University School of Medicine, Japan.
AJNR Am J Neuroradiol. 2003 Sep;24(8):1575-81.
To our knowledge, inner structural alterations of the hippocampus have never been demonstrated because of the lack of contrast between the hippocampus proper and the superficial medullary lamina. We sought to demonstrate the anatomic details of the inner hippocampus and to elucidate its alterations in Alzheimer disease (AD) in vivo.
We obtained multishot diffusion- and T2-weighted MR images in 14 healthy control subjects and 26 patients with mild or moderate AD (diagnosis based on Mini-Mental Status Examination scores). We measured the width of the subiculum, CA1 and CA3-4, and the height of CA3-4 on coronal images.
The subiculum and hippocampus proper were demonstrated as whirlpool-shaped hyperintense areas, and the superficial medullary lamina was visible as a hypointense structure along the inner margin of the hippocampus proper. Regarding the width of the subiculum and CA1, intergroup analysis revealed significant differences between the control and mild or moderate AD groups. In the width of CA3-4, we found no significant difference between the control and mild AD groups; however, differences between the control and moderate AD groups and between the mild and moderate AD groups were significant. In the height of CA3-4, we observed no significant differences between groups.
We clearly visualized the inner structure of the hippocampal formation by using multishot diffusion-weighted imaging. The subiculum and CA1 are the most vulnerable regions in AD, and atrophy of these structures was evident in both mild and moderate AD.
据我们所知，由于海马体本身与浅髓板之间缺乏对比度，海马体的内部结构改变从未得到证实。我们试图在活体中展示海马体内部的解剖细节，并阐明其在阿尔茨海默病（AD）中的改变。
我们获取了14名健康对照者和26名轻度或中度AD患者（根据简易精神状态检查表评分进行诊断）的多次激发扩散加权和T2加权磁共振图像。我们在冠状图像上测量了海马下脚、CA1和CA3 - 4的宽度以及CA3 - 4的高度。
海马下脚和海马体本身表现为漩涡状高信号区域，浅髓板可见为沿海马体本身内缘的低信号结构。关于海马下脚和CA1的宽度，组间分析显示对照组与轻度或中度AD组之间存在显著差异。在CA3 - 4的宽度方面，我们发现对照组与轻度AD组之间无显著差异；然而，对照组与中度AD组之间以及轻度与中度AD组之间的差异是显著的。在CA3 - 4的高度方面，我们观察到组间无显著差异。
我们通过使用多次激发扩散加权成像清晰地可视化了海马结构的内部结构。海马下脚和CA1是AD中最易受损的区域，在轻度和中度AD中这些结构的萎缩都很明显。
