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Congress: ECR25
Poster Number: C-16231
Type: Poster: EPOS Radiologist (educational)
Authorblock: M. Kancharla, S. R. Kankara, D. Jayanna, S. Suresh, A. R. Menezes, M. Maria, S. Reddy K; Bangalore/IN
Disclosures:
Meghana Kancharla: Nothing to disclose
Shreyas Reddy Kankara: Nothing to disclose
Dhanush Jayanna: Nothing to disclose
Siddhanth Suresh: Nothing to disclose
Anna Rachel Menezes: Nothing to disclose
Minnu Maria: Nothing to disclose
Shravan Reddy K: Nothing to disclose
Keywords: CNS, Neuroradiology brain, Vascular, MR, MR-Angiography, MR-Diffusion/Perfusion, Contrast agent-intravenous, Dilation, Normal variants, Infection, Inflammation, Neoplasia
Learning objectives The-aim-of-this-review-is-to-uncover-the-normal-microanatomy-of-perivascular-spaces-(PVS);homeostasis-of-the-glymphatic-system;and-explore-the-neuroimaging-of-their-highly-versatile-relationship-with-various-pathologies-including-congenital,inflammatory,vasculitic,neoplastic,infectious-and-neurodegenerative-conditions-which-can-present-with-abnormal-dilatation-or-enhancement-of-PVS[15].
Read more Background MICROANATOMY AND PHYSIOLOGY:Willem-et-al.,using electron-microscopy, found that arteries near anterior-perforated-substance and within globus-pallidus are surrounded by two leptomeningeal-layers, forming distinct periarterial-spaces. Conversely, cortical periarterial-spaces are bordered internally by adventitia and smooth-muscle cells, and externally by one leptomeningeal-layer. In basal-ganglia, PVS around veins appear continuous with subpial-space, and PVS in both humans and rodents communicate with basal-subarachnoid-space[1-3]. The PVS function as conduits facilitating the exchange of extracellular-fluid within brain-tissue and CSF in the subarachnoid-space.  [fig 1] The brain contains 4 fluid-compartments: cerebrospinal-fluid(CSF),interstitial-fluid(ISF), intracellular-fluid, and blood-vasculature....
Read more Findings and procedure details 1)CONGENITAL: MUCOPOLYSACCHARIDOSIS: Caused-by lysosomal-enzyme-deficiencies, resulting in impaired glycosaminoglycan(GAG)-metabolism and subsequent intracellular-GAG-accumulation[16]. The mechanism underlying PVS-enlargement in MPS remains unclear but has been observed in types -I, II, IIIA, IIIB, IIIC, and VI[17-19].Neuropathology: Hallmark-feature of MPS is the enlargement of the PVS, filled with a network of fibrous-tissue interspersed with cells-containing abnormal storage-material due to BBB-disruption and microvascular-leakage leading to perivascular-edema. Proposed theories attribute PVS-dilation either to abnormal-CSF-resorption at arachnoid-villi due to leptomeningeal-GAG-deposits or to direct-GAG-storage around vessels[20]. While degree of PVS-enlargement depends...
Read more Conclusion Understanding-the-anatomy-and-pathophysiologic-basis-of-neuroimaging-manifestations-of-PVS-is-essential-for-establishing-underlying-causality-and-thereby-diagnostic-interpretation-of-various-disease-pathologies-associated-with-glymphatic-pathway-dysfunction.
Read more References 1. POLLOCK H, HUTCHINGS M, WELLER RO, ZHANG ET. Perivascular spaces in the basal ganglia of the human brain: their relationship to lacunes. J Anat. 1997 Oct;191(Pt 3):337–46.2. Bouvy WH, Biessels GJ, Kuijf HJ, Kappelle LJ, Luijten PR, Zwanenburg JJM. Visualization of perivascular spaces andperforating arteries with 7 T magnetic resonance imaging. Invest Radiol. 2014 May;49(5):307–13.3. Agarwal N, Carare RO. Cerebral Vessels: An Overview of Anatomy, Physiology, and Role in the Drainage of Fluids and Solutes. Front Neurol. 2021 Jan...
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