Radiology (Neuroradiology), University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA.
Malabar Medical College, Kozhikode, Kerala, India.
Neuroradiol J. 2023 Oct;36(5):506-514. doi: 10.1177/19714009221122250. Epub 2022 Aug 22.
Microscopic neuroanatomy of limbic system and basal forebrain on MRI is complex and is a terra incognita for many radiologists, clinicians, and neuroscientists. Interestingly, most of the important structures/at least anatomical regions containing these structures demonstrable on cadaveric and surgical dissections can be identified on clinical MRI, with 3T being much better than 1.5T. This article teaches the practical MRI identification of these structures which will greatly help in evaluating complex ailments like temporal lobe epilepsy, Alzheimer dementia, and other neuropsychiatric disorders. This knowledge will also aid in accurate reporting of tumor spread along the white matter fasciculi in the temporal stem/basal forebrain region. Limbic system includes the mesial temporal structures and their connections, piriform cortex including "area tempestas," and the septal area comprising of subcallosal area and paraterminal gyrus. Basal forebrain includes structures like substantia innominata with basal nucleus of Meynert, diagonal gyrus/diagonal band of Broca, and nucleus accumbens lying in between the anterior perforated substance inferiorly and the anterior commissure superiorly.
边缘系统和基底前脑的微观神经解剖在 MRI 上较为复杂,许多放射科医生、临床医生和神经科学家对此都不甚了解。有趣的是,大多数重要的结构/至少包含这些结构的解剖区域都可以在尸体解剖和手术解剖中得到证实,而 3T 比 1.5T 效果更好。本文介绍了这些结构的实用 MRI 识别方法,这将极大地有助于评估颞叶癫痫、阿尔茨海默病痴呆和其他神经精神疾病等复杂疾病。这些知识还有助于准确报告肿瘤在颞叶干/基底前脑区域沿白质纤维束的扩散。边缘系统包括内侧颞叶结构及其连接、梨状皮层(包括“tempestas 区”)和隔区,包括胼胝体下区和终板旁回。基底前脑包括无名质体与梅内尔特基底核、斜角回/布罗卡斜角带和伏隔核等结构,这些结构位于下方的前穿质和上方的前连合之间。