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MRI brain perivascular spaces

Physiology: - perivascular spaces comprise the outer space between the pial membrane & astrocyte endfeet - perivascular spaces include passageways around arterioles, capillaries & venules in the brain, along which clearance of interstitial fluid & waste from the brain occurs, particularly during sleep [3] - they comprise the terminal end of Virchow-Robin spaces - perivascular spaces are involved in clearing brain waste & belong to the glymphatic system [5] Pathology: - enlarged MRI brain perivascular spaces may be proxy measure of cerebral small vessel disease, glymphatic dysfunction & risk of dementia [1] - microbleeds, cerebral amyloid angiopathy & enlarged perivascular spaces often occur in the preclinical stages of Alzheimer's disease, preceding brain atrophy [5,6] - perivascular spaces play a role in neuroinflammation [4] - enlarged perivascular spaces in the centrum semiovale identified in patients with chronic or episodic migraine vs healthy controls [2] - extension & infiltration of glioblastoma multiforme occurs along perivascular spaces Radiology: - ultra-high-field 7T MRI used to identify enlarged perivascular spaces in the centrum semiovale of patients with migraine

Related

glymphatic clearance; glymphatic flow (glymphatic system)

General

abnormal imaging

References

  1. Romero JR et al. MRI visible perivascular spaces and risk of incident dementia: The Framingham Heart Study. Neurology 2022 Sep 29; [e-pub]. PMID: 36175148 https://n.neurology.org/content/early/2022/09/29/WNL.0000000000201293
  2. Susman E Ultra-High-Res MRI Highlights Migraine Brain Changes. Patients had significant changes in perivascular spaces. MedPage Today December 1, 2022 https://www.medpagetoday.com/meetingcoverage/rsna/101993
  3. Wardlaw JM, Benveniste H, Nedergaard M et al Perivascular spaces in the brain: anatomy, physiology and pathology Nat Rev Neurol. 2020 Mar;16(3):137-153. PMID: 32094487 Review.
  4. Ineichen BV, Okar SV, Proulx ST et al Perivascular spaces and their role in neuroinflammation Neuron. 2022 Nov 2;110(21):3566-3581. PMID: 36327898 Review.
  5. Gouveia-Freitas K, Bastos-Leite AJ. Perivascular spaces and brain waste clearance systems: relevance for neurodegenerative and cerebrovascular pathology. Neuroradiology. 2021 Oct;63(10):1581-1597. PMID: 34019111 PMCID: PMC8460534 Free PMC article. Review.
  6. Lynch M, Pham W, Sinclair B et al Perivascular spaces as a potential biomarker of Alzheimer's disease Front Neurosci. 2022 Oct 18;16:1021131. PMID: 36330347 PMCID: PMC9623161 Free PMC article. Review.