MRI-based definition of a stereotactic two-dimensional template of the human insula.
OBJECTIVE
This study aimed to create a stereotactic two-dimensional description of the human insula based on accurate radiological morphometric studies.


METHODS
Seventy-five normal cerebral MRIs were selected and drawings of the insula then obtained from serial sagittal slices. These drawings were digitalized before superimposing the anterior (AC) and posterior (PC) commissures as references. This allowed us to quantify interindividual anatomical variations in a large cohort of subjects.


RESULTS
The morphometric analysis of the insula revealed a more complex shape than previously described. This structure is delimited by four peri-insular sulci (anterior, superior, posterior and inferior) instead of the three sulci classically mentioned. Males have a statistically larger surface area than females, according to a correlated index. Precise measurements of the different insular components allowed us to quantify their potential interindividual anatomical variations and to define their average shapes and stereotactic locations.


CONCLUSIONS
These data create a two-dimensional template of the human insula, with regard to the classical AC-PC stereotactic reference system. They furthermore allow us to quantify the probability that a given element of this structure is located at a predefined position. This should be useful in functional neuroimaging studies and in insular surgery for diagnostic and therapeutic goals.
Afif
Afif
A
Department of Neurosurgery, Neurological Hospital, Hospices civils de Lyon, Lyon, France. afif_acc@hotmail.com
Hoffmann
Dominique
D
Becq
Guillaume
G
Guenot
Marc
M
Magnin
Michel
M
Mertens
Patrick
P
D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D019635:Neurosurgical Procedures; D013238:Stereotaxic Techniques; D055815:Young Adult