Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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MRI Findings of Acute Hippocampal Disorders: Pictorial Essay

급성기 해마 질환의 자기공명영상 소견: 임상화보

  • Sangmin Park (Department of Radiology, Eulji University Hospital) ;
  • In Kyu Yu (Department of Radiology, Eulji University Hospital) ;
  • Hayoun Kim (Department of Radiology, Eulji University Hospital)
  • 박상민 (을지대학교병원 영상의학과) ;
  • 유인규 (을지대학교병원 영상의학과) ;
  • 김하연 (을지대학교병원 영상의학과)
  • Received : 2021.05.31
  • Accepted : 2021.09.23
  • Published : 2022.09.01
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Abstract

The hippocampus is one of the most metabolically active regions of the brain; therefore, it may be affected by various acute disorders. This study aimed to introduce and categorize various acute conditions that can involve the hippocampus and explain the findings of MRI, especially diffusion-weighted imaging (DWI). Acute hippocampal disorders are divided into six categories: infection, inflammation, metabolic, ischemic, traumatic, and miscellaneous. In this study, patients were retrospectively reviewed based on clinical findings and MRI, especially DWI. All diseases had been confirmed clinically or pathologically. Many acute hippocampal disorders overlap with the clinical manifestations. Thus, it is necessary to categorize acute hippocampal lesions and understand their specific imaging findings for differential diagnosis.

해마는 뇌에서 가장 대사가 활발한 부위 중 하나이다. 그러므로 해마는 다양한 급성기 질환으로부터 영향을 받을 수 있다. 이 연구의 목적은 해마와 관련된 다양한 질환들을 소개 및 분류하며 특히 확산강조영상을 중심으로 자기공명영상 소견에 대해 설명하는 것이다. 급성기 해마 질환은 감염, 염증, 대사성, 허혈성, 외상성 그리고 기타 총 6가지로 분류하였다. 환자들은 임상적 소견 그리고 확산강조영상 중심의 자기공명영상을 토대로 후향적으로 검토되었다. 모든 질환들은 임상적 또는 병리학적으로 진단되었다. 급성기 해마 질환들은 임상 양상이 겹치는 경우가 많다. 그러므로 감별 진단을 위해서 급성기 해마 질환들을 분류하고 각각의 특징적인 영상 소견을 이해하는 것이 중요하다.

Keywords

References

  1. Moscovitch M, Rosenbaum RS, Gilboa A, Addis DR, Westmacott R, Grady C, et al. Functional neuroanatomy of remote episodic, semantic and spatial memory: a unified account based on multiple trace theory. J Anat 2005;207:35-66 https://doi.org/10.1111/j.1469-7580.2005.00421.x
  2. Duvernoy HM. The human hippocampus: functional anatomy, vascularization and serial sections with MRI. Berlin: Springer 2005
  3. Kimberlin DW. Herpes simplex virus infections of the central nervous system. Semin Pediatr Infect Dis 2003;14:83-89 https://doi.org/10.1053/spid.2003.127224
  4. Whitley RJ, Soong SJ, Linneman C Jr, Liu C, Pazin G, Alford CA. Herpes simplex encephalitis. Clinical assessment. JAMA 1982;247:317-320 https://doi.org/10.1001/jama.1982.03320280037026
  5. Bulakbasi N, Kocaoglu M. Central nervous system infections of herpesvirus family. Neuroimaging Clin N Am 2008;18:53-84 https://doi.org/10.1016/j.nic.2007.12.001
  6. Soares BP, Provenzale JM. Imaging of herpesvirus infections of the CNS. AJR Am J Roentgenol 2016;206:39-48 https://doi.org/10.2214/AJR.15.15314
  7. Siu JCW, Chan CY, Wong YC, Yuen MK. Magnetic resonance imaging findings of Japanese encephalitis. J HK Coll Radiol 2004;7:76-80
  8. Kumar S, Misra UK, Kalita J, Salwani V, Gupta RK, Gujral R. MRI in Japanese encephalitis. Neuroradiology 1997;39:180-184 https://doi.org/10.1007/s002340050388
  9. Koeller KK, Shih RY. Viral and prion infections of the central nervous system: radiologic-pathologic correlation: from the radiologic pathology archives. Radiographics 2017;37:199-233 https://doi.org/10.1148/rg.2017160149
  10. Urbach H, Soeder BM, Jeub M, Klockgether T, Meyer B, Bien CG. Serial MRI of limbic encephalitis. Neuroradiology 2006;48:380-386 https://doi.org/10.1007/s00234-006-0069-0
  11. Thuerl C, Muller K, Laubenberger J, Volk B, Langer M. MR imaging of autopsy-proved paraneoplastic limbic encephalitis in non-Hodgkin lymphoma. AJNR Am J Neuroradiol 2003;24:507-511
  12. Cianci V, Labate A, Lanza P, Vincent A, Gambardella A, Branca D, et al. Non-paraneoplastic limbic encephalitis characterized by mesio-temporal seizures and extratemporal lesions: a case report. Seizure 2010;19:446-449 https://doi.org/10.1016/j.seizure.2010.06.002
  13. Chatzikonstantinou A, Szabo K, Ottomeyer C, Kern R, Hennerici MG. Successive affection of bilateral temporomesial structures in a case of non-paraneoplastic limbic encephalitis demonstrated by serial MRI and FDG-PET. J Neurol 2009;256:1753-1755 https://doi.org/10.1007/s00415-009-5165-8
  14. Abboud H, Probasco JC, Irani S, Ances B, Benavides DR, Bradshaw M, et al. Autoimmune encephalitis: proposed best practice recommendations for diagnosis and acute management. J Neurol Neurosurg Psychiatry 2021;92:757-768 https://doi.org/10.1136/jnnp-2020-325300
  15. Brierley JB, Corsellis JAN, Hierons R, Nevin S. Subacute encephalitis of later adult life. Mainly affecting the limbic areas. Brain 1960;83:357-368 https://doi.org/10.1093/brain/83.3.357
  16. Cho SJ, Minn YK, Kwon KH. Severe hypoglycemia and vulnerability of the brain. Arch Neurol 2006;63:138
  17. Kang EG, Jeon SJ, Choi SS, Song CJ, Yu IK. Diffusion MR imaging of hypoglycemic encephalopathy. AJNR Am J Neuroradiol 2010;31:559-564 https://doi.org/10.3174/ajnr.A1856
  18. Pai V, Sitoh YY, Purohit B. Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions. Insights Imaging 2020;11:20
  19. Fujioka M, Okuchi K, Hiramatsu KI, Sakaki T, Sakaguchi S, Ishii Y. Specific changes in human brain after hypoglycemic injury. Stroke 1997;28:584-587 https://doi.org/10.1161/01.STR.28.3.584
  20. Ott BR, Saver JL. Unilateral amnesic stroke. Six new cases and a review of the literature. Stroke 1993;24:1033-1042 https://doi.org/10.1161/01.STR.24.7.1033
  21. Takahashi S, Higano S, Kurihara N, Mugikura S, Sakamoto K, Nomura H, et al. Correlation of lesions in the hippocampal region noted on MR images with clinical features. Eur Radiol 1997;7:281-286 https://doi.org/10.1007/s003300050151
  22. Allen LM, Hasso AN, Handwerker J, Farid H. Sequence-specific MR imaging findings that are useful in dating ischemic stroke. Radiographics 2012;32:1285-1297 https://doi.org/10.1148/rg.325115760
  23. Huang BY, Castillo M. Hypoxic-ischemic brain injury: imaging findings from birth to adulthood. Radiographics 2008;28:417-439 https://doi.org/10.1148/rg.282075066
  24. Wijdicks EF, Campeau NG, Miller GM. MR imaging in comatose survivors of cardiac resuscitation. AJNR Am J Neuroradiol 2001;22:1561-1565
  25. Konaka K, Miyashita K, Naritomi H. Changes in diffusion-weighted magnetic resonance imaging findings in the acute and subacute phases of anoxic encephalopathy. J Stroke Cerebrovasc Dis 2007;16:82-83 https://doi.org/10.1016/j.jstrokecerebrovasdis.2006.10.007
  26. Maurya VK, Ravikumar R, Bhatia M, Rai R. Hypoxic-Ischemic brain injury in an adult: magnetic resonance imaging findings. Med J Armed Forces India 2016;72:75-77 https://doi.org/10.1016/j.mjafi.2015.06.016
  27. Adams JH. Diffuse axonal injury in non-missile head injury. Injury 1982;13:444-445 https://doi.org/10.1016/0020-1383(82)90105-X
  28. Adams JH. The autopsy in fatal non-missile head injuries. Curr Top Pathol 1988;76:1-22 https://doi.org/10.1007/978-3-642-71353-8_1
  29. Chung SW, Park YS, Nam TK, Kwon JT, Min BK, Hwang SN. Locations and clinical significance of non-hemorrhagic brain lesions in diffuse axonal injuries. J Korean Neurosurg Soc 2012;52:377-383 https://doi.org/10.3340/jkns.2012.52.4.377
  30. Daniel J, Cho Y, von Borstel D, Summers K. Decoding the diffusion: overview of restricted diffusion on brain MRI. J Am Osteopath Coll Radiol 2020;9:20-31
  31. Wintermark M, Sanelli PC, Anzai Y, Tsiouris AJ, Whitlow CT; ACR Head Injury Institute. Imaging evidence and recommendations for traumatic brain injury: conventional neuroimaging techniques. J Am Coll Radiol 2015;12:e1-e14 https://doi.org/10.1016/j.jacr.2014.10.014
  32. Bender MB. Syndrome of isolated episode of confusion with amnesia. J Hillside Hosp 1956;5:212-215
  33. Cianfoni A, Tartaglione T, Gaudino S, Pilato F, Saturno E, Tonali PA, et al. Hippocampal magnetic resonance imaging abnormalities in transient global amnesia. Arch Neurol 2005;62:1468-1469 https://doi.org/10.1001/archneur.62.9.1468
  34. Jan K, Chuin S. A case of recurrent transient global amnesia: don't forget the hippocampal punctuate diffusion restriction. Oxf Med Case Reports 2018;2018:omy025
  35. Bartsch T, Alfke K, Stingele R, Rohr A, Freitag-Wolf S, Jansen O, et al. Selective affection of hippocampal CA-1 neurons in patients with transient global amnesia without long-term sequelae. Brain 2006;129:2874-2884 https://doi.org/10.1093/brain/awl248
  36. Williams JA, Bede P, Doherty CP. An exploration of the spectrum of peri-ictal MRI change; a comprehensive literature review. Seizure 2017;50:19-32 https://doi.org/10.1016/j.seizure.2017.05.005
  37. Szabo K, Poepel A, Pohlmann-Eden B, Hirsch J, Back T, Sedlaczek O, et al. Diffusion-weighted and perfusion MRI demonstrates parenchymal changes in complex partial status epilepticus. Brain 2005;128:1369-1376 https://doi.org/10.1093/brain/awh454
  38. Kim JA, Chung JI, Yoon PH, Kim DI, Chung TS, Kim EJ, et al. Transient MR signal changes in patients with generalized tonicoclonic seizure or status epilepticus: periictal diffusion-weighted imaging. AJNR Am J Neuroradiol 2001;22:1149-1160