title: Prognostic value of CA4/DG volumetry with 3T magnetic resonance imaging on postoperative outcome of epilepsy patients with dentate gyrus pathology.
abstract: OBJECTIVE
  Hippocampal sclerosis (HS), the most common feature of mesial temporal lobe epilepsy (MTLE), is widely accepted as surgical indication for refractory epilepsy. Pathological hallmarks in hippocampal dentate gyrus (DG), including granule cell loss (GCL) and granule cell dispersion (GCD), are known to be closely related to the status epilepticus and spontaneous seizure. Our aim was to assess the association between volumetric changes in the hippocampal CA4/DG determined with 3-Tesla (3T) magnetic resonance imaging (MRI) and the postoperative seizure outcomes in MTLE patients with or without dentate gyrus pathology (DGP).
  
  
  METHODS
  High-resolution T2- and T1-weighted three-dimensional (3D) MRI scans were performed on 39 MTLE patients before surgery with a 3T Philips scanner. ITK-SNAP software was used for segmentation and volumetry of the CA4/DG segment, and NASP software was used for 3D reconstructions of the CA4/DG region. Immunostaining for Neuronal Nuclei (NeuN) was performed on resected hippocampal specimens after surgery to verify the accuracy of CA4/DG segmentation and histopathological changes in DG.
  
  
  RESULTS
  The CA4/DG subfield could be precisely segmented with high-resolution 3T MRI and confirmed by comparison of NeuN-immunoreactive slices with MRI results. MTLE patients with DGP showed smaller CA4/DG volume and favorable postoperative seizure outcomes.
  
  
  CONCLUSIONS
  The volumetry of CA4/DG was associated with the pathological changes in DG in MTLE patients. The volumetry of CA4/DG with preoperative 3T MRI could predict the postoperative seizure outcomes in those patients.
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China. Electronic address: nameng2001@hotmail.com.
authors.forename: Meng
authors.initials: M
authors.lastname: Na
authors.affiliation: Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Harbin Medical University, Harbin, China. Electronic address: 214289100@qq.com.
authors.forename: Yanshu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, New York University Langone Medical Center and School of Medicine, New York, NY, USA. Electronic address: Chen.Shi@med.nyu.edu.
authors.forename: Chen
authors.initials: C
authors.lastname: Shi
authors.affiliation: School of Life Science and Technology, Harbin Institute of Technology, Harbin, China. Electronic address: 14578921@qq.com.
authors.forename: Wenpeng
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China. Electronic address: 976954990@qq.com.
authors.forename: Haitao
authors.initials: H
authors.lastname: Ge
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China. Electronic address: 534236078@qq.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China. Electronic address: 243736614@qq.com.
authors.forename: Haiyang
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China. Electronic address: 979430042@qq.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Long
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China. Electronic address: shenhong67@aliyun.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Shen
authors.affiliation: Section of Neurosurgery/Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA. Electronic address: cshi@surgery.bsd.uchicago.edu.
authors.forename: Changbin
authors.initials: C
authors.lastname: Shi
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China. Electronic address: linzhiguonm@gmail.com.
authors.forename: Zhiguo
authors.initials: Z
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D018891:Dentate Gyrus / Q000473:pathology* / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult
keywords: Dentate gyrus pathology; Hippocampal sclerosis; Mesial temporal lobe epilepsy; Postoperative outcome