On the definition, construction, and presentation of the human cerebral sulci: A morphology-based approach.

Although the term sulcus is known for almost four centuries, its formal, precise, consistent, constructive, and quantitative definition is practically lacking. As the cerebral sulci (and gyri) are vital in cortical anatomy which, in turn, is central in neuroeducation and neuroimage processing, a new sulcus definition is needed. The contribution of this work is threefold, namely to (1) propose a new, morphology-based definition of the term sulcus (and consequently that of gyrus), (2) formulate a constructive method for sulcus calculation, and (3) provide a novel way for the presentation of sulci. The sulcus is defined here as a volumetric region on the cortical mantle between adjacent gyri separated from them at the levels of their gyral white matter crest lines. Consequently, the sulcal inner surface is demarcated by the crest lines of the gyral white matter of its adjacent gyri. Correspondingly, the gyrus is defined as a volumetric region on the cortical mantle separated from its adjacent sulci at the level of its gyral white matter crest line. This volumetric sulcus definition is conceptually simple, anatomy-based, educationally friendly, quantitative, and constructive. Considering the sulcus as a volumetric object is a major differentiation from other works. Based on the introduced sulcus definition, a method for volumetric sulcus construction is proposed in two, conceptually straightforward, steps, namely, sulcal intersection formation followed by its propagation which steps are to be repeated for every sulcal segment. These sulcal and gyral constructions can be automated by applying existing methods and public tools. As a volumetric sulcus forms an imprint into the white matter, this enables prominent sulcus presentation. Since this type of presentation is novel yet unfamiliar to the reader, also a dual surface presentation was proposed here by employing the spatially co-registered white matter and cortical surfaces. The results were presented as dual surface labeled sulci on eight standard orthogonal views, anterior, left lateral, posterior, right lateral, superior, inferior, medial left, and medial right by using a 3D brain atlas. Moreover, additional 108 labeled images were created with sulcus-oriented views for 27 individual left and right sulci forming 54 dual white matter-cortical surface images strengthening in this way the educational value of the proposed approach. These images were included for public use in the NOWinBRAIN neuroimage repository with over 7700 3D images available at www.nowinbrain.org. The results demonstrated the superiority of white matter surface sulci presentation over the standard cortical surface and cross-sectional presentations in terms of sulcal course, continuity, size, shape, width, depth, side branches, and pattern. To my best knowledge, this is the first work ever presenting the labeling of sulci on all cerebral white matter surfaces as well as on dual white matter-cortical surfaces. Additionally to neuroeducation, three other applications of the proposed approach were discussed, sulcal reference maps, sulcus quantification in terms of new parameters introduced here (sulcal volume, wall skewness, and the number of white matter basins), and an atlas-assisted tool for exploration and studying of cerebral sulci and gyri .