Morphometric MRI Analysis

  • Hans-Jürgen Huppertz
Part of the Medical Radiology book series (MEDRAD)


Morphometric MRI analysis may facilitate the detection and visualization of focal cortical dysplasia and other potentially epileptogenic cortical malformations by highlighting structural alterations such as abnormal gyration, blurring of the gray-white matter junction, and abnormal thickness of the cortical ribbon. In this chapter, a voxel-based implementation of this kind of MRI postprocessing using algorithms of the SPM5 software is presented. The description of methods is accompanied by illustrative examples which show how this approach may aid in the detection of subtle cortical dysplasia, polymicrogyria and gray matter heterotopia, in the delineation of the extent of lesions, and in the differentiation between different types of lesions. Thereby, it increases the diagnostic yield of MRI and appears to be a useful additional tool in the diagnostics and especially presurgical evaluation of epilepsy patients.  


Focal Cortical Dysplasia Normal Database Focal Cortical Dysplasia Type Thickness Image Periventricular Nodular Heterotopia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Altenmüller DM, Huppertz HJ (2006) Kombinierter Einsatz von morphometrischer MRT-analyse und gezielter invasiver EEG-Diagnostik bei fokaler kortikaler Dysplasie. Epileptologie 3:117–125Google Scholar
  2. Antel SB, Bernasconi A, Bernasconi N, Collins DL, Kearney RE, Shinghal R, Arnold DL (2002) Computational models of MRI characteristics of focal cortical dysplasia improve lesion detection. Neuroimage 17:1755–1760PubMedCrossRefGoogle Scholar
  3. Antel SB, Collins DL, Bernasconi N, Andermann F, Shinghal R, Kearney RE, Arnold DL, Bernasconi A (2003) Automated detection of focal cortical dysplasia lesions using computational models of their MRI characteristics and texture analysis. Neuroimage 19:1748–1759PubMedCrossRefGoogle Scholar
  4. Ashburner J, Friston KJ (2005) Unified segmentation. Neuroimage 26:839–851PubMedCrossRefGoogle Scholar
  5. Barkovich AJ, Kuzniecky RI (1996) Neuroimaging of focal malformations of cortical development. J Clin Neurophysiol 13:481–494PubMedCrossRefGoogle Scholar
  6. Barkovich AJ, Kuzniecky RI, Dobyns WB (2001) Radiologic classification of malformations of cortical development. Curr Opin Neurol 14:145–149PubMedCrossRefGoogle Scholar
  7. Bastos AC, Comeau RM, Andermann F, Melanson D, Cendes F, Dubeau F, Fontaine S, Tampieri D, Olivier A (1999) Diagnosis of subtle focal dysplastic lesions: curvilinear reformatting from three-dimensional magnetic resonance imaging. Ann Neurol 46:88–94PubMedCrossRefGoogle Scholar
  8. Berg AT, Vickrey BG, Langfitt JT, Sperling MR, Walczak TS, Shinnar S, Bazil CW, Pacia SV, Spencer SS (2003) The multicenter study of epilepsy surgery: recruitment and selection for surgery. Epilepsia 44:1425–1433PubMedCrossRefGoogle Scholar
  9. Bernasconi A, Antel SB, Collins DL, Bernasconi N, Olivier A, Dubeau F, Pike GB, Andermann F, Arnold DL (2001) Texture analysis and morphological processing of magnetic resonance imaging assist detection of focal cortical dysplasia in extra-temporal partial epilepsy. Ann Neurol 49:770–775PubMedCrossRefGoogle Scholar
  10. Bernasconi A, Bernasconi N, Bernhardt BC, Schrader D (2011) Advances in MRI for ‘cryptogenic’ epilepsies. Nat Rev Neurol 7:99–108PubMedCrossRefGoogle Scholar
  11. Besson P, Bernasconi N, Colliot O, Evans A, Bernasconi A (2008a) Surface-based texture and morphological analysis detects subtle cortical dysplasia. Med Image Comput Comput Assist Interv 11:645–652PubMedGoogle Scholar
  12. Besson P, Bernasconi N, Colliot O, Evans A, Bernasconi A (2008b) Surface-based texture and morphological analysis detects subtle cortical dysplasia. Med Image Comput Comput Assist Interv11:645–652PubMedGoogle Scholar
  13. Bien CG, Szinay M, Wagner J, Clusmann H, Becker AJ, Urbach H (2009) Characteristics and surgical outcomes of patients with refractory magnetic resonance imaging-negative epilepsies. Arch Neurol 66:1491–1499PubMedCrossRefGoogle Scholar
  14. Bonilha L, Montenegro MA, Rorden C, Castellano G, Guerreiro MM, Cendes F, Li LM (2006) Voxel-based morphometry reveals excess gray matter concentration in patients with focal cortical dysplasia. Epilepsia 47:908–915PubMedCrossRefGoogle Scholar
  15. Bruggemann JM, Wilke M, Som SS, Bye AM, Bleasel A, Lawson JA (2007) Voxel-based morphometry in the detection of dysplasia and neoplasia in childhood epilepsy: combined grey/white matter analysis augments detection. Epilepsy Res 77:93–101PubMedCrossRefGoogle Scholar
  16. Chan S, Chin SS, Nordli DR, Goodman RR, DeLaPaz RL, Pedley TA (1998) Prospective magnetic resonance imaging identification of focal cortical dysplasia, including the non-balloon cell subtype. Ann Neurol 44:749–757PubMedCrossRefGoogle Scholar
  17. Colliot O, Bernasconi N, Khalili N, Antel SB, Naessens V, Bernasconi A (2006) Individual voxel-based analysis of gray matter in focal cortical dysplasia. Neuroimage 29:162–171PubMedCrossRefGoogle Scholar
  18. Fauser S, Schulze-Bonhage A, Honegger J, Carmona H, Huppertz HJ, Pantazis G, Rona S, Bast T, Strobl K, Steinhoff BJ, Korinthenberg R, Rating D, Volk B, Zentner J (2004) Focal cortical dysplasias: surgical outcome in 67 patients in relation to histological subtypes and dual pathology. Brain 127:2406–2418PubMedCrossRefGoogle Scholar
  19. Fischl B, Dale AM (2000) Measuring the thickness of the human cerebral cortex from magnetic resonance images. Proc Natl Acad Sci USA 97:11050–11055PubMedCrossRefGoogle Scholar
  20. Focke NK, Symms MR, Burdett JL, Duncan JS (2008) Voxel-based analysis of whole brain FLAIR at 3 T detects focal cortical dysplasia. Epilepsia 49:786–793PubMedCrossRefGoogle Scholar
  21. Gomez-Anson B, Thom M, Moran N, Stevens J, Scaravilli F (2000) Imaging and radiological-pathological correlation in histologically proven cases of focal cortical dysplasia and other glial and neuronoglial malformative lesions in adults. Neuroradiology 42:157–167PubMedCrossRefGoogle Scholar
  22. Hagemann G, Redecker C, Witte OW (2000) Cortical dysgenesis: current classification, MRI diagnosis, and clinical review. Nervenarzt 71:616–628PubMedCrossRefGoogle Scholar
  23. Hildebrandt M, Pieper T, Winkler P, Kolodziejczyk D, Holthausen H, Blümcke I (2005) Neuropathological spectrum of cortical dysplasia in children with severe focal epilepsies. Acta Neuropathol (Berl) 110:1–11CrossRefGoogle Scholar
  24. Huppertz HJ, Grimm C, Fauser S, Kassubek J, Mader I, Hochmuth A, Spreer J, Schulze-Bonhage A (2005) Enhanced visualization of blurred gray−white matter junctions in focal cortical dysplasia by voxel-based 3D MRI analysis. Epilepsy Res 67:35–50PubMedCrossRefGoogle Scholar
  25. Huppertz HJ, Wellmer J, Staack AM, Altenmuller DM, Urbach H, Kroll J (2008) Voxel-based 3D MRI analysis helps to detect subtle forms of subcortical band heterotopia. Epilepsia 49:772–785PubMedCrossRefGoogle Scholar
  26. Kassubek J, Huppertz HJ, Spreer J, Schulze-Bonhage A (2002) Detection and localization of focal cortical dysplasia by voxel-based 3-D MRI analysis. Epilepsia 43:596–602PubMedCrossRefGoogle Scholar
  27. Kröll J, Huppertz HJ (2008) Nachweis von postoperativ verbliebenem dysplastischen Kortex mittels morphometrischer MRI-Analyse. Schweiz Z Psychiatr Neurol 2:17–20Google Scholar
  28. Kröll-Seger J, Grunwald T, Mothersill IW, Bernays R, Krämer G, Huppertz HJ (2011) Lachen ohne Heiterkeit––Morphometrische MRT-analyse in der prächirurgischen Abklärung einer MRT-negativen kindlichen Epilepsie mit gelastischen Anfällen. Epileptologie 28(2):78–83Google Scholar
  29. Krsek P, Maton B, Korman B, Pacheco-Jacome E, Jayakar P, Dunoyer C, Rey G, Morrison G, Ragheb J, Vinters HV, Resnick T, Duchowny M (2008) Different features of histopathological subtypes of pediatric focal cortical dysplasia. Ann Neurol 63:758–769PubMedCrossRefGoogle Scholar
  30. Kuzniecky R, Murro A, King D, Morawetz R, Smith J, Powers R, Yaghmai F, Faught E, Gallagher B, Snead OC (1993) Magnetic resonance imaging in childhood intractable partial epilepsies: pathologic correlations. Neurology 43:681–687PubMedCrossRefGoogle Scholar
  31. Kuzniecky R, Morawetz R, Faught E, Black L (1995) Frontal and central lobe focal dysplasia: clinical, EEG and imaging features. Dev Med Child Neurol 37:159–166PubMedCrossRefGoogle Scholar
  32. Lerner JT, Salamon N, Hauptman JS, Velasco TR, Hemb M, Wu JY, Sankar R, Donald SW, Engel J Jr, Fried I, Cepeda C, Andre VM, Levine MS, Miyata H, Yong WH, Vinters HV, Mathern GW (2009) Assessment and surgical outcomes for mild type I and severe type II cortical dysplasia: a critical review and the UCLA experience. Epilepsia 50:1310–1335PubMedCrossRefGoogle Scholar
  33. Merschhemke M, Mitchell TN, Free SL, Hammers A, Kinton L, Siddiqui A, Stevens J, Kendall B, Meencke HJ, Duncan JS (2003) Quantitative MRI detects abnormalities in relatives of patients with epilepsy and malformations of cortical development. Neuroimage 18:642–649PubMedCrossRefGoogle Scholar
  34. Palmini A, Luders HO (2002) Classification issues in malformations caused by abnormalities of cortical development. Neurosurg Clin N Am 13:1–16Google Scholar
  35. Raymond AA, Fish DR, Sisodiya SM, Alsanjari N, Stevens JM, Shorvon SD (1995) Abnormalities of gyration, heterotopias, tuberous sclerosis, focal cortical dysplasia, microdysgenesis, dysembryoplastic neuroepithelial tumour and dysgenesis of the archicortex in epilepsy. Clinical, EEG and neuroimaging features in 100 adult patients. Brain 118(Pt 3):629–660Google Scholar
  36. Redecker C, Hagemann G, Gressens P, Evrard P, Witte OW (2000) Cortical dysgenesis. Current views on pathogenesis and pathophysiology. Nervenarzt 71:238–248PubMedCrossRefGoogle Scholar
  37. Rugg-Gunn FJ, Boulby PA, Symms MR, Barker GJ, Duncan JS (2005) Whole-brain T2 mapping demonstrates occult abnormalities in focal epilepsy. Neurology 64:318–325PubMedCrossRefGoogle Scholar
  38. Salmenpera TM, Symms MR, Rugg-Gunn FJ, Boulby PA, Free SL, Barker GJ, Yousry TA, Duncan JS (2007) Evaluation of quantitative magnetic resonance imaging contrasts in MRI-negative refractory focal epilepsy. Epilepsia 48:229–237PubMedCrossRefGoogle Scholar
  39. Scott ML, Bromiley PA, Thacker NA, Hutchinson CE, Jackson A (2009) A fast, model-independent method for cerebral cortical thickness estimation using MRI. Med Image Anal 13:269–285PubMedCrossRefGoogle Scholar
  40. Semah F, Picot MC, Adam C, Broglin D, Arzimanoglou A, Bazin B, Cavalcanti D, Baulac M (1998) Is the underlying cause of epilepsy a major prognostic factor for recurrence? Neurology 51:1256–1262PubMedCrossRefGoogle Scholar
  41. Sisodiya SM, Free SL, Fish DR, Shorvon SD (1995a) Increasing the yield from volumetric MRI in patients with epilepsy. Magn Reson Imaging 13:1147–1152PubMedCrossRefGoogle Scholar
  42. Sisodiya SM, Free SL, Stevens JM, Fish DR, Shorvon SD (1995b) Widespread cerebral structural changes in patients with cortical dysgenesis and epilepsy. Brain 118:1039–1050PubMedCrossRefGoogle Scholar
  43. Speck O, Tempelmann C, Matzen J, Huppertz HJ (2009) Morphometric MRI analysis based on high resolution 3D imaging at 7 tesla highlights focal cortical dysplasia in epilepsy. Proc Intl Soc Mag Reson Med 17:971Google Scholar
  44. Tassi L, Colombo N, Garbelli R, Francione S, Lo RG, Mai R, Cardinale F, Cossu M, Ferrario A, Galli C, Bramerio M, Citterio A, Spreafico R (2002) Focal cortical dysplasia: neuropathological subtypes, EEG, neuroimaging and surgical outcome. Brain 125:1719–1732PubMedCrossRefGoogle Scholar
  45. Thesen T, Quinn BT, Carlson C, Devinsky O, DuBois J, McDonald CR, French J, Leventer R, Felsovalyi O, Wang X, Halgren E, Kuzniecky R (2011) Detection of epileptogenic cortical malformations with surface-based MRI morphometry. PLoS One 6:e16430PubMedCrossRefGoogle Scholar
  46. Urbach H, Scheffler B, Heinrichsmeier T, von Oertzen J, Kral T, Wellmer J, Schramm J, Wiestler OD, Blümcke I (2002) Focal cortical dysplasia of Taylor’s balloon cell type: a clinicopathological entity with characteristic neuroimaging and histopathological features, and favorable postsurgical outcome. Epilepsia 43:33–40PubMedCrossRefGoogle Scholar
  47. Wagner J, Weber B, Urbach H, Elger CE, Huppertz HJ (2011) Morphometric MRI analysis improves detection of focal cortical dysplasia type II. Brain 13:2844–2854CrossRefGoogle Scholar
  48. Wellmer J, Parpaley Y, von Lehe M, Huppertz HJ (2010) Integrating MRI post-processing results into neuronavigation for electrode implantation and resection of subtle focal cortical dysplasia in previously cryptogenic epilepsy. Neurosurgery 66:187–194PubMedCrossRefGoogle Scholar
  49. Widdess-Walsh P, Diehl B, Najm I (2006) Neuroimaging of focal cortical dysplasia. J Neuroimaging 16:185–196PubMedCrossRefGoogle Scholar
  50. Wilke M, Kassubek J, Ziyeh S, Schulze-Bonhage A, Huppertz HJ (2003) Automated detection of gray matter malformations using optimized voxel-based morphometry: a systematic approach. Neuroimage 20:330–343PubMedCrossRefGoogle Scholar
  51. Woermann FG, Free SL, Koepp MJ, Ashburner J, Duncan JS (1999) Voxel-by-voxel comparison of automatically segmented cerebral gray matter—a rater-independent comparison of structural MRI in patients with epilepsy. Neuroimage 10:373–384PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Swiss Epilepsy CentreZurichSwitzerland

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