Opercular perivascular cysts: A proposed new subtype of dilated perivascular spaces

McArdle, David John Tobias; Lovell, Timothy John Haynes; Lekgabe, Ernest; Gaillard, Frank

doi:10.1016/j.ejrad.2020.108838

Cited by 8 publications

(8 citation statements)

References 13 publications

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“…Increasing space requirements and/or vascular pulsations of tortuous arteries could lead to dilation of perivascular spaces (Figure 3B). A similar mechanism has been proposed for MVPVS of the anterior temporal lobe: vascular tortuosity could lead to compression of small communicating fluid channels resulting in opercular perivascular cysts (Salzman et al, 2005;McArdle et al, 2020). Here, a tortuous middle cerebral artery branch could compress communicating fluid channels between the subarachnoid and perivascular spaces in the adjacent cortex.…”

Section: Hypothesis On Spiral Elongation Of Vessels/tortuous Vesselsmentioning

confidence: 75%

“…Typical locations of MVPVS are in the basal ganglia along lenticulostriate vessels, centrum semiovale, and midbrain (ponto-mesencephalic junction) ( Kwee and Kwee, 2007 ). Less frequent MVPVS locations are: insula ( Yamaguchi et al, 2021 ), hippocampus ( Zhu et al, 2011 ), anterior temporal lobe ( McArdle et al, 2020 ), corpus callosum ( Manara et al, 2010 , 2011 ), mesencephalon-thalamic junction ( Salzman et al, 2005 ), and cerebellum ( Alqahtani et al, 2014 ). Although many agree that MVPVS should be an imaging component of cerebral vessel disease ( Francis et al, 2019 ), emerging data suggest that it can also be a feature of metabolic ( Manara et al, 2011 ), neurodegenerative ( Charidimou et al, 2017 ), and neuroinflammatory diseases ( Granberg et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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The etiology and evolution of magnetic resonance imaging-visible perivascular spaces: Systematic review and meta-analysis

Okar

Shinohara

et al. 2023

Front. Neurosci.

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ObjectivesPerivascular spaces have been involved in neuroinflammatory and neurodegenerative diseases. Upon a certain size, these spaces can become visible on magnetic resonance imaging (MRI), referred to as enlarged perivascular spaces (EPVS) or MRI-visible perivascular spaces (MVPVS). However, the lack of systematic evidence on etiology and temporal dynamics of MVPVS hampers their diagnostic utility as MRI biomarker. Thus, the goal of this systematic review was to summarize potential etiologies and evolution of MVPVS.MethodsIn a comprehensive literature search, out of 1,488 unique publications, 140 records assessing etiopathogenesis and dynamics of MVPVS were eligible for a qualitative summary. 6 records were included in a meta-analysis to assess the association between MVPVS and brain atrophy.ResultsFour overarching and partly overlapping etiologies of MVPVS have been proposed: (1) Impairment of interstitial fluid circulation, (2) Spiral elongation of arteries, (3) Brain atrophy and/or perivascular myelin loss, and (4) Immune cell accumulation in the perivascular space. The meta-analysis in patients with neuroinflammatory diseases did not support an association between MVPVS and brain volume measures [R: −0.15 (95%-CI −0.40–0.11)]. Based on few and mostly small studies in tumefactive MVPVS and in vascular and neuroinflammatory diseases, temporal evolution of MVPVS is slow.ConclusionCollectively, this study provides high-grade evidence for MVPVS etiopathogenesis and temporal dynamics. Although several potential etiologies for MVPVS emergence have been proposed, they are only partially supported by data. Advanced MRI methods should be employed to further dissect etiopathogenesis and evolution of MVPVS. This can benefit their implementation as an imaging biomarker.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346564, identifier CRD42022346564.

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Section: Hypothesis On Spiral Elongation Of Vessels/tortuous Vesselsmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

The etiology and evolution of magnetic resonance imaging-visible perivascular spaces: Systematic review and meta-analysis

Okar

Shinohara

et al. 2023

Front. Neurosci.

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“…The author suggested that it should be considered as a separate subtype of perivascular spaces, namely type IV perivascular spaces, and proposed the term “opercular perivascular cyst” as naming. This type of PVS exhibits the same internal signal characteristics as CSF in all MRI sequences, without contrast enhancement or magnetic susceptibility artifacts, and the brain parenchyma surrounding the lesion shows variable high signal on T2WI and FLAIR ( 60 ).…”

Section: Mr Imaging Of Perivascular Spacesmentioning

confidence: 93%

“…A recent study described an enlarged perivascular space located in the anterior temporal lobe with unique neuroimaging features ( 60 ). It occured in association with the vascular loop of the middle cerebral artery (MCA) branch and often compressed the adjacent cortex, with edema around the lesion.…”

Section: Mr Imaging Of Perivascular Spacesmentioning

confidence: 99%

Perivascular Spaces, Glymphatic System and MR

et al. 2022

Front. Neurol.

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The importance of the perivascular space (PVS) as one of the imaging markers of cerebral small vessel disease (CSVD) has been widely appreciated by the neuroradiologists. The PVS surrounds the small blood vessels in the brain and has a signal consistent with the cerebrospinal fluid (CSF) on MR. In a variety of physio-pathological statuses, the PVS may expand. The discovery of the cerebral glymphatic system has provided a revolutionary perspective to elucidate its pathophysiological mechanisms. Research on the function and pathogenesis of this system has become a prevalent topic among neuroradiologists. It is now believed that this system carries out the similar functions as the lymphatic system in other parts of the body and plays an important role in the removal of metabolic waste and the maintenance of homeostatic fluid circulation in the brain. In this article, we will briefly describe the composition of the cerebral glymphatic system, the influencing factors, the MR manifestations of the PVS and the related imaging technological advances. The aim of this research is to provide a reference for future clinical studies of the PVS and glymphatic system.

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“…난형중심의 PVS는 뇌백질의 바깥쪽에서 측뇌실(lateral ventricle)을 향해 주행하는 방향으로 존재하게 되며, 그 외에도 해마, 중뇌, 교뇌 혹은 소뇌에서도 관찰할 수 있는데, 대체로 한 부분에 PVS를 여러 개 가지고 있는 사람은 PVS가 특징적으로 보이는 다른 위치에서도 다수의 PVS를 보이게 된다( 38 ). 최근에는 anterior temporal lobe도 특징적인 PVS의 위치로 보고한다( 39 40 ). MRI에서 보이는 PVS가 세동맥을 둘러싼 구조물인지 세정맥을 둘러싼 구조물인지 아니면 둘 다인지에 대해서는 논란이 있었으나 7T를 이용한 연구에서( 41 ) 자기공명영상에서 보이는 PVS는 세정맥이 아닌 세동맥 주변의 구조물이라고 발표하였고, susceptibility 영상에서도 난형중심의 PVS는 세정맥은 PVS와는 관련 없는 것으로 보고하였다( 41 ).…”

Section: Pvs의 영상해부학및 병리적 영상 소견unclassified

An Enlarged Perivascular Space: Clinical Relevance and the Role of Imaging in Aging and Neurologic Disorders

Yim

Moon

2022

J Korean Soc Radiol

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혈관주위공간(perivascular space; 이하 PVS)는 뇌 실질을 관통하는 세동맥 둘러싸고 있는 공간으로, 최근에는 별아교세포의 종족(astrocyte endfoot)에 의해 가장 바깥쪽이 경계지워지는, 체액, 세포, 결합조직으로 구성된 혈관벽내, 혈관벽 주위의 구획을 모두 아우르는 개념으로 이해하고 있다. 정상적으로는 현미경적 해부학 구조물이지만 이 구조물이 늘어나게 되면 MRI T1 혹은 T2 이미지에서 확인할 수 있게 된다. PVS의 명확한 실체나 임상적인 의의에 대해서는 아직 분명치 않은 부분이 많이 있지만 PVS의 확장(enlarged PVS; 이하 EPVS)은 다양한 퇴행성 뇌질환 뿐만 아니라 뇌출혈 및 외상성 뇌손상, 당뇨성 신질환 같은 다양한 질병과의 연관성이 있다는 연구 결과들이 발표되고 있다. 이번 종설에서는 PVS와 EPVS가 가지는 임상적 의의와 병태 생리에 대한 최근 문헌을 고찰하고, MRI를 이용한 정성적 평가 및 최적화에 대해 논의해 보고자 한다.

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Opercular perivascular cysts: A proposed new subtype of dilated perivascular spaces

Cited by 8 publications

References 13 publications

The etiology and evolution of magnetic resonance imaging-visible perivascular spaces: Systematic review and meta-analysis

The etiology and evolution of magnetic resonance imaging-visible perivascular spaces: Systematic review and meta-analysis

Perivascular Spaces, Glymphatic System and MR

An Enlarged Perivascular Space: Clinical Relevance and the Role of Imaging in Aging and Neurologic Disorders

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