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Hippocampal T2 hyperintensities on 7 Tesla MRI

van Veluw, Susanne J ; Wisse, Laura E M LU orcid ; Kuijf, Hugo J ; Spliet, Wim G M ; Hendrikse, Jeroen ; Luijten, Peter R ; Geerlings, Mirjam I and Biessels, Geert Jan (2013) In NeuroImage: Clinical 3. p.196-201
Abstract

Hippocampal focal T2 hyperintensities (HT2Hs), also referred to as hippocampal sulcal cavities, are a common finding on Magnetic Resonance (MR) images. There is uncertainty about their etiology and clinical significance. In this study we aimed to describe these HT2Hs in more detail using high resolution 7 Tesla MR imaging, addressing 1) the MR signal characteristics of HT2Hs, 2) their occurrence frequency, 3) their location within the hippocampus, and 4) their relation with age. We also performed an explorative post-mortem study to examine the histology of HT2Hs. Fifty-eight persons without a history of invalidating neurological or psychiatric disease (mean age 64 ± 8 years; range 43-78 years), recruited through their general... (More)

Hippocampal focal T2 hyperintensities (HT2Hs), also referred to as hippocampal sulcal cavities, are a common finding on Magnetic Resonance (MR) images. There is uncertainty about their etiology and clinical significance. In this study we aimed to describe these HT2Hs in more detail using high resolution 7 Tesla MR imaging, addressing 1) the MR signal characteristics of HT2Hs, 2) their occurrence frequency, 3) their location within the hippocampus, and 4) their relation with age. We also performed an explorative post-mortem study to examine the histology of HT2Hs. Fifty-eight persons without a history of invalidating neurological or psychiatric disease (mean age 64 ± 8 years; range 43-78 years), recruited through their general practitioners, were included in this study. They all underwent 7 Tesla MRI, including a T1, T2, and FLAIR image. MR signal characteristics of the HT2Hs were assessed on these images by two raters. Also, the location and number of the HT2Hs were assessed. In addition, four formalin-fixed brain slices from two subjects were scanned overnight. HT2Hs identified in these slices were subjected to histopathological analysis. HT2Hs were present in 97% of the subjects (median number per person 10; range 0-20). All HT2Hs detected on the T2 sequence were hypointense on T1 weighted images. Of all HT2Hs, 94% was hypointense and 6% hyperintense on FLAIR. FLAIR hypointense HT2Hs were all located in the vestigial sulcus of the hippocampus, FLAIR hyperintense HT2Hs in the hippocampal sulcus or the gray matter. Post-mortem MRI and histopathological analysis suggested that the hypointense HT2Hs on FLAIR were cavities filled with cerebrospinal fluid. A hyperintense HT2H on FLAIR proved to be a microinfarct upon microscopy. In conclusion, hippocampal T2Hs are extremely common and unrelated to age. They can be divided into two types (hypo- and hyperintense on FLAIR), probably with different etiology.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Hippocampal sulcal cavities, Neuropathology, Fluid-attenuated inversion recovery, Perivascular spaces
in
NeuroImage: Clinical
volume
3
pages
6 pages
publisher
Elsevier
external identifiers
  • pmid:24179863
  • scopus:84883890249
ISSN
2213-1582
DOI
10.1016/j.nicl.2013.08.003
language
English
LU publication?
yes
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ea0c9e8a-bfa2-4e04-add0-1717d0037e1c
date added to LUP
2024-02-28 15:04:39
date last changed
2024-02-29 16:39:11
@article{ea0c9e8a-bfa2-4e04-add0-1717d0037e1c,
  abstract     = {{<p>Hippocampal focal T2 hyperintensities (HT2Hs), also referred to as hippocampal sulcal cavities, are a common finding on Magnetic Resonance (MR) images. There is uncertainty about their etiology and clinical significance. In this study we aimed to describe these HT2Hs in more detail using high resolution 7 Tesla MR imaging, addressing 1) the MR signal characteristics of HT2Hs, 2) their occurrence frequency, 3) their location within the hippocampus, and 4) their relation with age. We also performed an explorative post-mortem study to examine the histology of HT2Hs. Fifty-eight persons without a history of invalidating neurological or psychiatric disease (mean age 64 ± 8 years; range 43-78 years), recruited through their general practitioners, were included in this study. They all underwent 7 Tesla MRI, including a T1, T2, and FLAIR image. MR signal characteristics of the HT2Hs were assessed on these images by two raters. Also, the location and number of the HT2Hs were assessed. In addition, four formalin-fixed brain slices from two subjects were scanned overnight. HT2Hs identified in these slices were subjected to histopathological analysis. HT2Hs were present in 97% of the subjects (median number per person 10; range 0-20). All HT2Hs detected on the T2 sequence were hypointense on T1 weighted images. Of all HT2Hs, 94% was hypointense and 6% hyperintense on FLAIR. FLAIR hypointense HT2Hs were all located in the vestigial sulcus of the hippocampus, FLAIR hyperintense HT2Hs in the hippocampal sulcus or the gray matter. Post-mortem MRI and histopathological analysis suggested that the hypointense HT2Hs on FLAIR were cavities filled with cerebrospinal fluid. A hyperintense HT2H on FLAIR proved to be a microinfarct upon microscopy. In conclusion, hippocampal T2Hs are extremely common and unrelated to age. They can be divided into two types (hypo- and hyperintense on FLAIR), probably with different etiology.</p>}},
  author       = {{van Veluw, Susanne J and Wisse, Laura E M and Kuijf, Hugo J and Spliet, Wim G M and Hendrikse, Jeroen and Luijten, Peter R and Geerlings, Mirjam I and Biessels, Geert Jan}},
  issn         = {{2213-1582}},
  keywords     = {{Hippocampal sulcal cavities; Neuropathology; Fluid-attenuated inversion recovery; Perivascular spaces}},
  language     = {{eng}},
  pages        = {{196--201}},
  publisher    = {{Elsevier}},
  series       = {{NeuroImage: Clinical}},
  title        = {{Hippocampal T2 hyperintensities on 7 Tesla MRI}},
  url          = {{http://dx.doi.org/10.1016/j.nicl.2013.08.003}},
  doi          = {{10.1016/j.nicl.2013.08.003}},
  volume       = {{3}},
  year         = {{2013}},
}