Morphology of the Inner Structure of the Hippocampal Formation in Alzheimer Disease
Michito Adachia,
Shinobu Kawakatsub,
Takaaki Hosoyaa,
Koichi Otanib,
Tsuguo Honmaa,
Akiko Shibataa and
Yukio Sugaia
a Department of Radiology, Yamagata University School of Medicine, Japan
b Department of Psychiatry, Yamagata University School of Medicine, Japan
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FIG 1. Coronal photomicrographs of normal and atrophic hippocampus (Klüver-Barrera stain).
A, Image in a 56-year-old man with dentatorubro-pallidoluysian atrophy shows no atrophy of the left subiculum or hippocampus proper. Image represents a normal hippocampus. The hippocampus proper consists of the CA1, CA2, CA3, and CA4 fields. Bar indicates 1 mm.
B, Image in a 78-year-old man with AD (duration of illness, 15 years) shows severe atrophy of the subiculum (arrow). The superficial medullary lamina (arrowheads) is thinner than that of a normal hippocampus. Bar indicates 1 mm.
C, Magnified (x200) view of the image in A shows numerous nerve fibers running in the anteroposterior direction in the superficial medullary lamina of the hippocampal formation.
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FIG 2. Schematic representation of the hippocampal formation shows the measurement points for the subiculum and the hippocampus proper. PHG indicates the parahippocampal gyrus.
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FIG 3. Coronal MR images in a 59-year-old man (control subject).
A, Multishot diffusion-weighted image clearly shows the inner structure of the left hippocampus. The subiculum (left arrowhead), CA1 of the hippocampus proper (right arrowhead), and CA3–4 (top arrow) are demonstrated as hyperintense areas, and the superficial medullary lamina (bottom arrow) is shown as a hypointense area.
B, T2-weighted image faintly shows the subiculum (arrowhead), the hippocampus proper, and the superficial medullary lamina (arrow).
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FIG 4. MR images in a 71-year-old woman with mild AD (MMSE score, 27; duration of illness, 2 years).
A, Multishot diffusion-weighted coronal image shows atrophic subiculum (left arrowhead) and CA1 (right arrowhead). However, the CA3–4 (arrow) is spared.
B, T2-weighted image scarcely demonstrates the inner structure of the left hippocampus (arrow).
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FIG 5. MR images in a 68-year-old man with mild AD (MMSE score, 25; duration of illness, 3 years).
A, Multishot diffusion-weighted coronal image shows an atrophic subiculum (left arrowhead) and CA1 (right arrowhead). CA3–4 (arrow) is spared.
B, T2-weighted image scarcely demonstrates the inner structure of the left hippocampus (arrow).
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FIG 6. MR images in a 64-year-old woman with moderate AD (MMSE score, 8; duration of illness, 12 years).
A, Multishot diffusion-weighted coronal image shows an atrophic subiculum (left arrowhead). CA1 (right arrowhead) is comparatively spared; however, CA3–4 (arrow) is atrophic.
B, T2-weighted image scarcely demonstrates the inner structure of the left hippocampus (arrow).
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FIG 7. MR images in a 71-year-old woman with moderate AD (MMSE score, 6; duration of illness, 11 years).
A, Multishot diffusion-weighted coronal image shows severe atrophy of the subiculum (left arrowhead) and CA3–4 (small arrow). Atrophy of CA1 (right arrowhead) is mild. Image also shows atrophy of the parahippocampal gyrus (large arrow).
B, T2-weighted image barely shows the inner structure of the hippocampus (arrow).
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FIG 8. MR images in a 45-year-old man (control subject).
A, Multishot diffusion-weighted coronal image clearly shows the inner structure of the left hippocampus: the subiculum (left arrowhead), CA1 of the hippocampus proper (right arrowhead), CA3–4 (small arrow), and the superficial medullary lamina (large arrow).
B, T2-weighted coronal image faintly shows the superficial medullary lamina (arrow) as a hypointense area.
C, T1-weighted 3D volumetric SPGR image (26/4.3; FOV, 18 cm; matrix, 256 x 256; thickness, 0.8 mm; slab, 64 mm) shows the superficial medullary lamina (arrow) as a hyperintense area and depicts it more faintly than does the T2-weighted image.
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AJNR - American Journal of Neuroradiology