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Rofo 2024; 196(10): 1029-1036
DOI: 10.1055/a-2254-5651
Review

Perivaskuläre Räume und wo sie zu finden sind – MR-Bildgebung und Auswertungsmethoden

Article in several languages: English | deutsch
Svea Seehafer
  Clinic for Radiology and Neuroradiology, University Hospital Schleswig-Holstein – Campus Kiel, Germany
,
Naomi Larsen 
  Clinic for Radiology and Neuroradiology, University Hospital Schleswig-Holstein – Campus Kiel, Germany
,
Schekeb Aludin
  Clinic for Radiology and Neuroradiology, University Hospital Schleswig-Holstein – Campus Kiel, Germany
,
Olav Jansen
  Clinic for Radiology and Neuroradiology, University Hospital Schleswig-Holstein – Campus Kiel, Germany
,
Lars-Patrick Andreas Schmill
  Clinic for Radiology and Neuroradiology, University Hospital Schleswig-Holstein – Campus Kiel, Germany
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Zusammenfassung

Hintergrund Perivaskuläre Räume (Synonym: Virchow-Robin-Räume) wurden erstmals vor bereits über 150 Jahren beschrieben. Sie sind definiert als der flüssigkeitsgefüllte Raum in Umgebung der kleinen penetrierenden zerebralen Gefäße. Zunehmendes wissenschaftliches Interesse erlangten sie insbesondere mit der Postulation des sogenannten glymphatischen Systems und ihrer möglichen Bedeutung bei neurodegenerativen und -inflammatorischen Erkrankungen.

Methoden Es erfolgte eine gezielte PubMed-Recherche mit Fokus auf Arbeiten zur MR-Bildgebung und Auswertung von perivaskulären Räumen. Eingeschlossen wurden Arbeiten zur humanen in-vivo Bildgebung. Insbesondere auf Arbeiten zur gesunden Bevölkerung wurde geachtet. Eine Zeitraumbegrenzung erfolgte nicht. Die Nomenklatur in der Literatur ist sehr heterogen. Häufig wird beispielsweise von „large“, „dilated“, „enlarged“ perivaskulären Räumen gesprochen, wobei Grenzen und Definitionen meist unklar sind. In der vorliegenden Arbeit wird daher allgemein die Bezeichnung „Perivaskuläre Räume“ verwendet.

Ergebnisse Der vorliegende Übersichtsartikel erörtert die MR-morphologischen Charakteristika perivaskulärer Räume in verschiedenen Sequenzen. Mit der sich stetig verbessernden Bildqualität können auch zunehmend kleinere Strukturen immer detaillierter visualisiert werden. Es werden sowohl die Methoden der visuellen Auswertung als auch der semi- oder vollautomatischen Segmentierung kurz erläutert.

Schlussfolgerung Perivaskuläre Räume sind in quasi jeder kraniellen MRT-Untersuchung sichtbar, wenn man ihnen Beachtung schenkt. Ihr physiologischer oder pathologischer Wert ist weiterhin wissenschaftlicher Diskussionsgegenstand.

Kernaussagen 

  • Perivaskuläre Räume sind in quasi jeder kraniellen MRT-Bildgebung sichtbar, wenn man ihnen Beachtung schenkt.

  • Für die visuelle Auswertung eignen sich insbesondere T2-gewichtete Sequenzen. Zusätzliche Sequenzen können helfen, um sie von ihren Differenzialdiagnosen abzugrenzen.

  • Es gibt vielversprechende Ansätze für die semi- oder vollautomatische Segmentierung perivaskulärer Räume mit der Möglichkeit, weitere quantitative Parameter zu erheben.

Zitierweise

  • Seehafer S, Larsen N, Aludin S et al. Perivascular spaces and where to find them – MRI imaging and evaluation methods. Fortschr Röntgenstr 2024; 196: 1029 – 1036

Key words

perivascular spaces - glymphatic system - MR imaging


Publication History

Received: 06 November 2023

Accepted: 20 December 2023

Article published online:
26 February 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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