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Enlarged Perivascular Spaces
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Perivascular space (PVS)
                • Virchow-Robin space
              • Definitions

                • Channels in subpial space that accompany penetrating arteries into brain

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Francis F et al: Perivascular spaces and their associations with risk factors, clinical disorders and neuroimaging features: a systematic review and meta-analysis. Int J Stroke. 4(4):359-71, 2019
                                              2. Hilal S et al: Enlarged perivascular spaces and cognition: a meta-analysis of 5 population-based studies. Neurology. 91(9):e832-42, 2018
                                              3. Laveskog A et al: Perivascular spaces in old age: assessment, distribution, and correlation with white matter gyperintensities. AJNR Am J Neuroradiol. 39(1):70-6, 2018
                                              4. Niazi M et al: Quantitative MRI of perivascular spaces at 3T for early diagnosis of mild cognitive impairment. AJNR Am J Neuroradiol. 39(9):1622-8, 2018
                                              5. Riba-Llena I et al: Arterial stiffness is associated with basal ganglia enlarged perivascular spaces and cerebral small vessel disease load. Stroke. 49(5):1279-81, 2018
                                              6. Rudie JD et al: Neuroimaging of dilated perivascular spaces: from benign and pathologic causes to mimics. J Neuroimaging. 28(2):139-49, 2018
                                              7. Zhang X et al: Brain atrophy correlates with severe enlarged perivascular spaces in basal ganglia among lacunar stroke patients. PLoS One. 11(2):e0149593, 2016
                                              8. Potter GM et al: Enlarged perivascular spaces and cerebral small vessel disease. Int J Stroke. 10(3):376-81, 2015
                                              9. Huijts M et al: Basal ganglia enlarged perivascular spaces are linked to cognitive function in patients with cerebral small vessel disease. Curr Neurovasc Res. 11(2):136-41, 2014
                                              10. Yakushiji Y et al: Topography and associations of perivascular spaces in healthy adults: the Kashima scan study. Neurology. 83(23):2116-23, 2014
                                              11. Kara S et al: Dilated perivascular spaces: an informative radiologic finding in Sanfilippo syndrome type A. Pediatr Neurol. 38(5):363-6, 2008
                                              12. Stephens T et al: Giant tumefactive perivascular spaces. J Neurol Sci. 266(1-2):171-3, 2008
                                              13. Kwee RM et al: Virchow-Robin spaces at MR imaging. Radiographics. 27(4):1071-86, 2007
                                              14. Groeschel S et al: Virchow-Robin spaces on magnetic resonance images: normative data, their dilatation, and a review of the literature. Neuroradiology. 2006
                                              15. Salzman KL et al: Giant tumefactive perivascular spaces. AJNR Am J Neuroradiol. 26(2):298-305, 2005
                                              16. Papayannis CE et al: Expanding Virchow Robin spaces in the midbrain causing hydrocephalus. AJNR Am J Neuroradiol. 24(7):1399-403, 2003
                                              17. Ozturk MH et al: Comparison of MR signal intensities of cerebral perivascular (Virchow-Robin) and subarachnoid spaces. J Comput Assist Tomogr. 26(6):902-4, 2002
                                              18. Song CJ et al: MR imaging and histologic features of subinsular bright spots on T2-weighted MR images: Virchow-Robin spaces of the extreme capsule and insular cortex. Radiology. 214(3):671-7, 2000
                                              19. Adachi M et al: Dilated Virchow-Robin spaces: MRI pathological study. Neuroradiology. 40(1):27-31, 1998
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Perivascular space (PVS)
                                                            • Virchow-Robin space
                                                          • Definitions

                                                            • Channels in subpial space that accompany penetrating arteries into brain

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Nuclear Medicine Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Francis F et al: Perivascular spaces and their associations with risk factors, clinical disorders and neuroimaging features: a systematic review and meta-analysis. Int J Stroke. 4(4):359-71, 2019
                                                                                          2. Hilal S et al: Enlarged perivascular spaces and cognition: a meta-analysis of 5 population-based studies. Neurology. 91(9):e832-42, 2018
                                                                                          3. Laveskog A et al: Perivascular spaces in old age: assessment, distribution, and correlation with white matter gyperintensities. AJNR Am J Neuroradiol. 39(1):70-6, 2018
                                                                                          4. Niazi M et al: Quantitative MRI of perivascular spaces at 3T for early diagnosis of mild cognitive impairment. AJNR Am J Neuroradiol. 39(9):1622-8, 2018
                                                                                          5. Riba-Llena I et al: Arterial stiffness is associated with basal ganglia enlarged perivascular spaces and cerebral small vessel disease load. Stroke. 49(5):1279-81, 2018
                                                                                          6. Rudie JD et al: Neuroimaging of dilated perivascular spaces: from benign and pathologic causes to mimics. J Neuroimaging. 28(2):139-49, 2018
                                                                                          7. Zhang X et al: Brain atrophy correlates with severe enlarged perivascular spaces in basal ganglia among lacunar stroke patients. PLoS One. 11(2):e0149593, 2016
                                                                                          8. Potter GM et al: Enlarged perivascular spaces and cerebral small vessel disease. Int J Stroke. 10(3):376-81, 2015
                                                                                          9. Huijts M et al: Basal ganglia enlarged perivascular spaces are linked to cognitive function in patients with cerebral small vessel disease. Curr Neurovasc Res. 11(2):136-41, 2014
                                                                                          10. Yakushiji Y et al: Topography and associations of perivascular spaces in healthy adults: the Kashima scan study. Neurology. 83(23):2116-23, 2014
                                                                                          11. Kara S et al: Dilated perivascular spaces: an informative radiologic finding in Sanfilippo syndrome type A. Pediatr Neurol. 38(5):363-6, 2008
                                                                                          12. Stephens T et al: Giant tumefactive perivascular spaces. J Neurol Sci. 266(1-2):171-3, 2008
                                                                                          13. Kwee RM et al: Virchow-Robin spaces at MR imaging. Radiographics. 27(4):1071-86, 2007
                                                                                          14. Groeschel S et al: Virchow-Robin spaces on magnetic resonance images: normative data, their dilatation, and a review of the literature. Neuroradiology. 2006
                                                                                          15. Salzman KL et al: Giant tumefactive perivascular spaces. AJNR Am J Neuroradiol. 26(2):298-305, 2005
                                                                                          16. Papayannis CE et al: Expanding Virchow Robin spaces in the midbrain causing hydrocephalus. AJNR Am J Neuroradiol. 24(7):1399-403, 2003
                                                                                          17. Ozturk MH et al: Comparison of MR signal intensities of cerebral perivascular (Virchow-Robin) and subarachnoid spaces. J Comput Assist Tomogr. 26(6):902-4, 2002
                                                                                          18. Song CJ et al: MR imaging and histologic features of subinsular bright spots on T2-weighted MR images: Virchow-Robin spaces of the extreme capsule and insular cortex. Radiology. 214(3):671-7, 2000
                                                                                          19. Adachi M et al: Dilated Virchow-Robin spaces: MRI pathological study. Neuroradiology. 40(1):27-31, 1998