Objective:

The aim of this study was to reveal the magnetic resonance imaging (MRI) characteristics of perivascular spaces (PVSs) that help to differentiate them from other various intracranial cystic pathologies.

Materu0131al And Method:

From the archieves, retrospectively, a total of 11 cases with the complaints of headache, recent development of cognitive impairment and recent onset epilepsy whose radiological reports revealed atypically wide PVSs were included in this study (M:8, F:3, mean age: 44 years). PVSs were accepted as atypical when the diameter exceeded 1 cm or <1cm lesion had tendency towards confluence.

Results:

The dimensions of the lesions widened PVSs were in between 1 and 3,8 cm (mean 2,1 cm). In most of the cases, the lesions were located in left cerebral hemisphere and deep white matter of the occipital lobe. In two patients, the lesions were dominantly located at the frontal lobes. While the lesions in occipital deep white matter had a tendency towards confluence, lesions at the frontal lobe were rested separately. In only one case, which was evaluated for the new onset of epilepsy, the lesion caused a mass affect over hypocampus. In all the cases, enlarged PVSs were isointense with CSF and there was no restricted diffusion in neither of the cases. No contrast enhancement was seen in three cases for whom gadolinium was applied. All of the lesions were parallel to the trace of the main feding artery and on proton density images lesions were less hyperintense compared to the CSF.

Conclusu0131on:

Wide PVSs should be evaluated for their localizations, the presence of space occupying or mass effects, contrast enhancement, association with arterial vasculature, and accompanying perilesional white matter signal intensity changes. Proton density sequences must be included in the evaluation for the characteristic signal loss compared to other T2 images.

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