Brief Answer:
MRI of the hippocampus cannot be assessed on SINGLE SLICE show

Detailed Answer:
Good evening. I'm not sure if the arrow is supposed to be indicating the HIPPOCAMPUS but if so then, it is not in the right location. It is quite a bit inferior to (lower than) the actual location of this structure.

Secondly it is usually best to have at least several cuts on an MRI on each of side of the area of interest that one is looking at since MRI images are essentially a collection of slices that are typically 1-2mm. thick of the entire volume of the brain. X-rays are only single image shots. CT scans are also slices but typically 2-5x thicker than MRI therefore, if one were trying to do a 3D reconstruction to check VOLUME of an area then, several slices at least are needed to be able and accurately call something atrophied or not and by how much compared to normal.

Your single slice presentation therefore, takes away a lot of precision in making any formal determination as to the size or volume of the hippocampus.

Thirdly, It is often a better study when looking at "atrophied" areas of the brain to get contrasted or gadolinium studies in order to better outlines areas of scarring or encephalomalacia (brain shrinkage/atrophy) which sometimes show up more readily against normal brain tissue if any of the atrophied brain has not been consolidated yet.

To my eye, I cannot see any significant difference in the hippocampal region on the right or left that I would call important. I can tell you that the cut itself is slightly oblique and not directly at 90 degrees to the central axial plane. Perhaps, that is the reason why someone is trying to make an interpretation of smaller sized region on the right than left.

BTW, the ARROW is pointing to the LEFT side of the picture and not the right if the photograph is presented in the conventional and standard way. In MRI scans (as opposed to CT or x-rays) side of the viewer is on the opposite to the side of the brain being shown. In other words, what is on the RIGHT HAND SIDE OF THE PHOTOGRAPH per the reference point of the viewer is the LEFT side of the brain or skull and vice versa.

If your doctor was also imaging you for possible seizure disorder then, they should've ordered what WE refer to as a SEIZURE PROTOCOL image which is always contrasted with gadolinium. The slice you are illustrating is NOT and fine cuts through the MESIAL TEMPORAL LOBES is obtained on BOTH sides and atrophy is looked for in the CONTRASTED IMAGING sequences. Again, perhaps your doctor did all this and perhaps the radiologist also read all the images and sequences. If available, it would be more helpful to see the radiologist's final REPORT on this study as opposed to the slice of MRI you've provided.

In summary, there is no way for me (or anyone) to give you a good guess as to whether or not you have atrophy of the hippocampus since you've provided a single slice of a volumetric study. Secondly, images that need to be analyzed should be contrasted against non contrasted. It would be of more value if you wish an opinion to upload a copy of the neuroradiology report. In that report it should be explained whether or not the study obtained was done for the purpose of looking for a seizure disorder caused by hippocampal atrophy.

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This query has utilized a total of 60 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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