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Introduction: The aim of this study was to investigate whether the outline of the hippocampal body becomes rounded on coronal magnetic resonance imaging (MRI) as the volume of the hippocampal formation decreases in Alzheimer's disease (AD)., Methods: Institutional review board approval of the study protocol was obtained, and all subjects provided informed consent for the mini-mental state examination (MMSE) and MRI. The MRI and MMSE were prospectively performed in all 103 subjects (27 men and 76 women; mean age ± standard deviation, 77.7 ± 7.8 years) who had AD or were concerned about having of dementia and who consulted our institute over 1 year. The subjects included 14 non-dementia cases (MMSE score ≥ 28) and 89 AD cases (MMSE score ≤ 27). The total volume of the bilateral hippocampal formation (VHF) was assessed with a tracing method, and the ratio of the VHF to the intracranial volume (RVHF) and the rounding ratio (RR) of the hippocampal body (mean ratio of its short dimension to the long dimension in the bilateral hippocampal body) were calculated. Using Spearman's correlation coefficient, the correlations between RR and VHF and between RR and RVHF were assessed., Results: Correlation coefficients between RR and VHF and between RR and RVHF were -0.419 (p < 0.01) and -0.418 (p < 0.01), respectively. There was a significant negative correlation between RR and the volume of the hippocampal formation., Conclusion: The outline of the body of the hippocampal formation becomes rounded on coronal images as its volume decreases in AD.

Purpose: On routine coronal images, we have recognized atrophied hippocampi that appear round in patients with Alzheimer's disease (AD). The purpose of this study was to evaluate rounding of the hippocampus in patients with AD and to elucidate whether this change is a useful radiological marker of atrophy of the hippocampus., Materials and Methods: We enrolled 14 patients with moderate AD (Mini-Mental State Examination score 16.2 +/- 3.3) and 15 patients without dementia or neurological deficits as the control group. For measurement of the hippocampus, we used T2-weighted coronal images parallel to the floor of the fourth ventricle. Two observers measured the dimensions of the long and short axes of the hippocampal body of 28 hippocampi from 14 patients with AD and 30 hippocampi from 15 controls. As a marker of rounding of the hippocampal body, we calculated the ratio of the short axis length to the long axis length (the rounding ratio) of the hippocampus., Results: We observed apparent atrophy of the long axis of the hippocampus in patients with AD. An unpaired t-test indicated significant differences in the long axis length and the rounding ratio between the control and AD groups (P < 0.01) in the measurements of both observers. However, there was no significant difference in the short axis length. With a threshold of 0.7 in the rounding ratio, the sensitivity was 85.7% and the specificity was 66.7%., Conclusion: The hippocampus appears round on coronal images in the presence of moderate AD. The rounding ratio of the hippocampus is a useful and facile indicator of hippocampal atrophy.