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AJNR - American Journal of Neuroradiology

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New Morphologic Variants of the Hand Motor Cortex as Seen with MR Imaging in a Large Study Population

M. Caulo^a, C. Briganti^a, P.A. Mattei^a, B. Perfetti^a, A. Ferretti^a, G.L. Romani^a, A. Tartaro^a and C. Colosimo^b

^a From the Institute Advanced Biomedical Technologies of the Department of Clinical Sciences and Bioimaging, University "G. d’Annunzio," Chieti, Italy
^b Department of Radiology, Catholic University of Rome, Italy

View larger version (50K): [in this window] [in a new window]   Fig 1. Schematic representation of the criteria used for morphologic classification and corresponding MR image of a typical example. The position of the third fissure, which segments the knob, modifying its appearance from an omega to an epsilon in the lateral, central, or medial part of the hand knob indicates a medially asymmetric epsilon, epsilon, and laterally asymmetric epsilon, respectively. To distinguish an omega from a null, the height of the knob must be greater than the thickness of the precentral gyrus measured at the base of the knob. If the height is smaller than the thickness, the HMC is classified as null. Multiplanar reformatted MR imaging axial sections were obtained from left hemispheres 50 ± 2 mm above the Talairach ACPC plane. The red area in the MR images highlights the morphologic variant.

View larger version (65K): [in this window] [in a new window]   Fig 2. Multiplanar reformatted axial sections obtained 50 ± 2 mm above the Talairach anterior AC-PC plane. Images are shown using the right-left radiologic convention. The following are representative examples of the different combinations of HMC morphologic variants (red highlight) in the 2 hemispheres: A, Omega-omega. B, Epsilon-epsilon. C, Medially asymmetric epsilon-medially asymmetric epsilon. D, Laterally asymmetric epsilon-laterally asymmetric epsilon. E, Null-null. F, Epsilon-omega. G, Omega-laterally asymmetric epsilon. H, Omega-epsilon. I, Omega-medially asymmetric epsilon. J, Medially asymmetric epsilon-omega. The first 5 indicate concordant combinations, and the latter 5, the most common disconcordant combinations.