Hippocampal sclerosis (HS) is often associated with gray-white matter blurring (GMB) of the anterior temporal lobe. In this study, twenty patients with unilateral temporal lobe epilepsy and HS were studied with 3 T MRI including T1 MP2RAGE and DTI/DMI sequences. Anterior temporal lobe white matter T1 relaxation times and diffusion measures were analyzed on the HS side, on the contralateral side, and in 10 normal controls. Resected brain tissue of three patients without GMB and four patients with GMB was evaluated ultrastructurally regarding axon density and diameter, the relation of the axon diameter to the total fiber diameter (G-ratio), and the thickness of the myelin sheath. Hippocampal sclerosis GMB of the anterior temporal lobe was related to prolonged T1 relaxation and axonal loss. A less pronounced reduction in axonal fraction was also found on imaging in GMB-negative temporal poles compared with normal controls. Contralateral values did not differ significantly between patients and normal controls. Reduced axonal density and axonal diameter were histopathologically confirmed in the temporopolar white matter with GMB compared to temporal poles without. These results confirm that GMB can be considered an imaging correlate for disturbed axonal maturation that can be quantified with advanced diffusion imaging.

中文翻译：

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与海马硬化相关的颞极灰白质模糊：一项涉及 3 T MRI 和超微结构组织病理学的显微结构研究

海马硬化症 (HS) 通常与前颞叶的灰白质模糊 (GMB) 相关。在这项研究中，对 20 名单侧颞叶癫痫和 HS 患者进行了 3 T MRI 研究，包括 T1 MP2RAGE 和 DTI/DMI 序列。在 HS 侧、对侧和 10 个正常对照中分析了前颞叶白质 T1 弛豫时间和扩散测量值。对 3 名无 GMB 患者和 4 名 GMB 患者的切除脑组织进行超微结构评估，包括轴突密度和直径、轴突直径与总纤维直径 (G 比) 的关系以及髓鞘厚度。海马硬化 前颞叶的 GMB 与 T1 松弛时间延长和轴突丢失有关。与正常对照组相比，在 GMB 阴性颞极的成像中也发现轴突分数的减少不太明显。对侧值在患者和正常对照之间没有显着差异。与没有的颞极相比，具有 GMB 的颞极白质组织病理学证实轴突密度和轴突直径降低。这些结果证实，GMB 可以被认为是受干扰的轴突成熟的成像关联，可以通过先进的扩散成像进行量化。