Coronal high resolution T2
and FLAIR are best to diagnose MTS.
Findings include reduced
hippocampal volume that is hippocampal atrophy, increased T2 signal, abnormal
morphology that is loss of internal architecture and interdigitations of
hippocampus.
Although comparing with
opposite is easiest, it must be remembered that up to 10% of cases are
bilateral, and thus if symmetry is the only feature being evaluated, many cases
may be misinterpreted as normal.
Often mentioned, but
probably one of the least specific findings, is enlargement of the temporal
horn of the lateral ventricle. If anything, care must be taken to not allow an
enlarged horn to trick you to over diagnosis as hippocampal atrophy.
