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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:2141-2145, November-December 2006
© 2006 American Society of Neuroradiology

BRAIN

Hippocampal Sulcus Width and Cavities: Comparison Between Patients with Alzheimer Disease and Nondemented Elderly Subjects

A.J. Bastos-Leite^a,b, J.H. van Waesberghe^a, A.L. Oen^c, W.M. van der Flier^d, P. Scheltens^d and F. Barkhof^d

^a Department of Radiology and Image Analysis Center, VU University Medical Center, Amsterdam, the Netherlands
^b Department of Neuroradiology, Hospital Geral de Santo António, Oporto, Portugal
^c Department of Radiology, Laurentius Hospital, Roermond, the Netherlands
^d Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands

Please address correspondence to António José de Bastos-Leite, MD, Department of Radiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands; e-mail: A.bastosleite{at}vumc.nl

BACKGROUND AND PURPOSE:The hippocampal fissure is a fetal sulcus that, except for its most medial part (the superficial hippocampal sulcus), is normally obliterated. Hippocampal cavities are residual cysts attributable to lack of hippocampal fissure obliteration. We hypothesized that either hippocampal sulcus enlargement or an increase in number or size of hippocampal cavities could be associated with medial temporal lobe atrophy (MTA) occurring in Alzheimer disease.

METHODS:Two observers assessed the maximal hippocampal sulcus width by means of the fimbriosubicular distance at the anterior part of the hippocampal body; as well as the occurrence, number, and size of hippocampal cavities; and the visual rating score of MTA on magnified coronal high-resolution T1-weighted MR images of 21 patients with Alzheimer disease and 15 nondemented elderly controls.

RESULTS:Both observers found the maximal hippocampal sulcus width significantly larger in patients with Alzheimer disease than in controls (P < .0001). The interobserver averaged fimbriosubicular distance in patients with Alzheimer disease was 2.84 mm (SD = 0.94), approximately twice that of the corresponding distance in nondemented subjects (1.41 mm; SD, 0.58). Both observers found a significant correlation between the fimbriosubicular distance and MTA score (observer 1, r_s = 0.71; observer 2, r_s = 0.74; P < .0001). None of the observers found significant differences between patients with Alzheimer disease and nondemented subjects with respect to occurrence, number, or size of hippocampal cavities, nor did they find a significant correlation between the number or size of hippocampal cavities and MTA. Interobserver agreement ranged from moderate to very good.

CONCLUSION:Enlargement of the hippocampal sulcus, assessed by the fimbriosubicular distance, is associated with MTA in Alzheimer disease, but enlargement of the hippocampal cavities is not.