Tae Woo-Suk, Ham Byung-Joo, Pyun Sung-Bom, Kim Byung-Jo
Brain Convergence Research Center, Korea University College of Medicine, Seoul, Korea.
Department of Psychiatry, Korea University College of Medicine, Seoul, Korea.
J Clin Neurol. 2025 Jul;21(4):277-293. doi: 10.3988/jcn.2025.0185.
Structural magnetic resonance imaging (sMRI) plays a pivotal role in the evaluation of neurological disorders by providing high-resolution anatomical information. Recent advances in quantitative postprocessing techniques have expanded the utility of sMRI beyond visual assessments by enabling the detection of subtle morphological changes associated with various neurological and psychiatric conditions. This review summarizes current clinical applications of sMRI-based analysis, including brain volumetry, shape analysis, voxel-based morphometry (VBM), surface-based morphometry, source-based morphometry, and voxel-based lesion-symptom mapping (VLSM). Volumetric and shape-based analyses allow for assessments of region-specific atrophy and subregional morphological alterations, while VBM and surface-based morphometry provide complementary insights into tissue volumes and the architecture of the cortical surface. Source-based morphometry reveals network-level patterns of structural covariance, and VLSM directly correlates lesion locations with functional outcomes, particularly in stroke. It has been demonstrated that these methodologies are clinically relevant in conditions such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, epilepsy, and major depressive disorder. By quantifying structural brain alterations that are not readily detectable using conventional imaging methods, these tools improve diagnostic accuracy, support prognostication, and facilitate monitoring of treatment effects. This review highlights the growing integration of sMRI postprocessing techniques into clinical neurology.
结构磁共振成像（sMRI）通过提供高分辨率的解剖信息，在神经系统疾病评估中发挥着关键作用。定量后处理技术的最新进展通过能够检测与各种神经和精神疾病相关的细微形态变化，扩展了sMRI在视觉评估之外的用途。本综述总结了基于sMRI分析的当前临床应用，包括脑容量测定、形状分析、基于体素的形态测量（VBM）、基于表面的形态测量、基于源的形态测量以及基于体素的病变-症状映射（VLSM）。基于体积和形状的分析允许评估特定区域的萎缩和亚区域形态改变，而VBM和基于表面的形态测量则为组织体积和皮质表面结构提供了互补的见解。基于源的形态测量揭示了结构协方差的网络水平模式，而VLSM直接将病变位置与功能结果相关联，特别是在中风中。已经证明，这些方法在阿尔茨海默病、帕金森病、多发性硬化症、癫痫和重度抑郁症等疾病中具有临床相关性。通过量化使用传统成像方法不易检测到的脑结构改变，这些工具提高了诊断准确性，支持预后评估，并有助于监测治疗效果。本综述强调了sMRI后处理技术在临床神经病学中的日益融合。
