Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs.
Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs.
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DOI：
10.3389/fneur.2021.682615
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发表时间：
2021
影响因子：
3.4
通讯作者：
Balchandani P
中科院分区：
文献类型：
--
作者：
Pai A;Marcuse LV;Alper J;Delman BN;Rutland JW;Feldman RE;Hof PR;Fields M;Young J;Balchandani P
虽然癫痫患者海马硬化（HS）的病因仍不清楚，但海马亚区萎缩的不同表型与不同的临床表现和手术结果相关。超高场 7T 磁共振成像 (MRI) 和自动子场体积测定等新技术的出现进一步实现了癫痫患者海马病理的检测，然而，将 7T MRI 和自动分割结合起来治疗具有正常临床 MRI 的癫痫患者的研究有限。在这项研究中，我们提出了一种海马子区域自动分割 (ASHS) 软件的新应用，使用超高场 7T MRI 扫描（包括 T1 加权 MP2RAGE 和 T2-TSE 序列）来确定 CA1、CA2/3、CA4/DG 和下托的子区域体积，在 27 名患有内侧颞叶癫痫 (mTLE) 或新皮质癫痫 (NE) 的患者中进行比较年龄和性别与健康对照相匹配。我们发现，7T 改善了单侧 mTLE 患者临床强度 MRI 上未见的结构异常的可视化。此外，我们的自动分割算法能够检测与对照组相比，单侧 mTLE 患者海马亚区的体积和不对称性的结构差异。具体而言，在病程较长的单侧 mTLE 患者中，在同侧 CA1 和 CA2/3 亚区以及对侧 CA1 中观察到体积损失。与对照组相比，NE 患者的子视野体积没有差异。我们报告了 7T 与自动分割的首次应用，以描述该人群中特定海马亚区的病程负担与不对称性之间的关系。研究发现，在单侧 mTLE 队列中，疾病持续时间与亚场不对称性存在统计学上显着的正相关关系。这些发现强调了 7T MRI 和自动分割为癫痫患者提供新颖的定性和定量信息的能力，这些患者在临床领域强度上 MRI 呈阴性。
While the etiology of hippocampal sclerosis (HS) in epilepsy patients remains unknown, distinct phenotypes of hippocampal subfield atrophy have been associated with different clinical presentations and surgical outcomes. The advent of novel techniques including ultra-high field 7T magnetic resonance imaging (MRI) and automated subfield volumetry have further enabled detection of hippocampal pathology in patients with epilepsy, however, studies combining both 7T MRI and automated segmentation in epilepsy patients with normal-appearing clinical MRI are limited. In this study, we present a novel application of the automated segmentation of hippocampal subfields (ASHS) software to determine subfield volumes of the CA1, CA2/3, CA4/DG, and the subiculum using ultra high-field 7T MRI scans, including T1-weighted MP2RAGE and T2-TSE sequences, in 27 patients with either mesial temporal lobe epilepsy (mTLE) or neocortical epilepsy (NE) compared to age and gender matched healthy controls. We found that 7T improved visualization of structural abnormalities not otherwise seen on clinical strength MRIs in patients with unilateral mTLE. Additionally, our automated segmentation algorithm was able to detect structural differences in volume and asymmetry across hippocampal subfields in unilateral mTLE patients compared to controls. Specifically, amongst unilateral mTLE patients with longer disease durations, volume loss was observed in the ipsilateral CA1 and CA2/3 subfields and contralateral CA1. There were no differences in subfield volumes in patients with NE compared to controls. We report the first application of 7T with automated segmentation to characterize the relationship between disease duration burden and asymmetry across specific hippocampal subfields in this population. Disease duration was found to have a statistically significant positive relationship with subfield asymmetry within the unilateral mTLE cohort. These findings highlight the ability of 7T MRI and automated segmentation to provide novel qualitative and quantitative information in epilepsy patients who are otherwise MRI-negative at clinical field strengths.
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影响因子：
4.6
作者：
Voets NL;Hodgetts CJ;Sen A;Adcock JE;Emir U
通讯作者：
Emir U
影响因子：
5.6
作者：
Winston GP;Cardoso MJ;Williams EJ;Burdett JL;Bartlett PA;Espak M;Behr C;Duncan JS;Ourselin S
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影响因子：
3.7
作者：
Feldman, Rebecca Emily;Delman, Bradley Neil;Balchandani, Priti
通讯作者：
Balchandani, Priti
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影响因子：
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作者：
Mueller SG;Laxer KD;Barakos J;Cheong I;Garcia P;Weiner MW
通讯作者：
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影响因子：
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作者：
Shah, Preya;Bassett, Danielle S.;Davis, Kathryn A.
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