Inserm, Jean-Pierre Aubert Research Center, U837, Development and Plasticity of the postnatal Brain, Univ Lille Nord de France, CHRU Lille, Department of Neurosurgery, Lille University Hospital, 59037 Lille cedex, France.
Neuroimage. 2012 Jan 2;59(1):168-80. doi: 10.1016/j.neuroimage.2011.07.013. Epub 2011 Jul 14.
Gaining new insights into the anatomy of the human hypothalamus is crucial for the development of new treatment strategies involving functional stereotactic neurosurgery. Here, using anatomical comparisons between histology and magnetic resonance images of the human hypothalamus in the coronal plane, we show that discrete gray and white hypothalamic structures are consistently identifiable by MRI. Macroscopic and microscopic images were used to precisely annotate the MRI sequences realized in the coronal plane in twenty healthy volunteers. MRI was performed on a 1.5 T scanner, using a protocol including T1-weighted 3D fast field echo, T1-weighted inversion-recovery, turbo spin echo and T2-weighted 2D fast field echo imaging. For each gray matter structure as well as for white matter bundles, the different MRI sequences were analyzed in comparison to each other. The anterior commissure and the fornix were often identifiable, while the mammillothalamic tract was more difficult to spot. Qualitative analyses showed that MRI could also highlight finer structures such as the paraventricular nucleus, the ventromedial nucleus of the hypothalamus and the infundibular (arcuate) nucleus, brain nuclei that play key roles in the regulation of food intake and energy homeostasis. The posterior hypothalamic area, a target for deep brain stimulation in the treatment of cluster headaches, was readily identified, as was the lateral hypothalamic area, which similar to the aforementioned hypothalamic nuclei, could be a putative target for deep brain stimulation in the treatment of obesity. Finally, each of the identified structures was mapped to Montreal Neurological Institute (MNI) space.
深入了解人类下丘脑的解剖结构对于开发涉及功能立体定向神经外科的新治疗策略至关重要。在这里，我们通过对人类下丘脑冠状面的组织学和磁共振图像进行解剖比较，显示出离散的灰色和白色下丘脑结构在 MRI 上始终可以识别。使用宏观和微观图像，我们精确地注释了在二十名健康志愿者中在冠状面实现的 MRI 序列。MRI 在 1.5 T 扫描仪上进行，使用包括 T1 加权 3D 快速场回波、T1 加权反转恢复、涡轮自旋回波和 T2 加权 2D 快速场回波成像的协议。对于每个灰质结构以及白质束，我们分析了不同的 MRI 序列彼此之间的关系。前连合和穹窿经常可以识别，而乳头体丘脑束则更难发现。定性分析表明，MRI 还可以突出显示更精细的结构，如室旁核、下丘脑腹内侧核和漏斗（弓状）核，这些核在调节摄食和能量平衡方面发挥着关键作用。深部脑刺激治疗丛集性头痛的靶点下丘脑后区，以及类似于上述下丘脑核的外侧下丘脑区，都很容易被识别，它们可能是治疗肥胖症的深部脑刺激的潜在靶点。最后，将每个识别出的结构映射到蒙特利尔神经学研究所（MNI）空间。
