Perivascular spaces and where to find them – MR imaging and evaluation methods

Abstract

Background Perivascular spaces (synonym: Virchow-Robin spaces) were first described over 150 years ago. They are defined as the fluid-filled spaces surrounding the small penetrating cerebral vessels. They gained growing scientific interest especially with the postulation of the so-called glymphatic system and their possible role in neurodegenerative and neuroinflammatory diseases.

Methods PubMed was used for a systematic search with a focus on literature regarding MRI imaging and evaluation methods of perivascular spaces. Studies on human in-vivo imaging were included with a focus on studies involving healthy populations. No time frame was set. The nomenclature in the literature is very heterogeneous with terms like “large”, “dilated”, “enlarged” perivascular spaces whereas borders and definitions often remain unclear. This work generally talks about perivascular spaces.

Results This review article discusses the morphologic MRI characteristics in different sequences. With the continual improvement of image quality, more and tinier structures can be depicted in detail. Visual analysis and semi or fully automated segmentation methods are briefly discussed.

Conclusion If they are looked for, perivascular spaces are apparent in basically every cranial MRI examination. Their physiologic or pathologic value is still under debate.

Key Points 

• Perivascular spaces can be seen in basically every cranial MRI examination.

• Primarily T2-weighend sequences are used for visual analysis. Additional sequences are helpful for distinction from their differential diagnoses.

• There are promising approaches for the semi or fully automated segmentation of perivascular spaces with the possibility to collect more quantitative parameters.

Citation Format

• 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

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