Enlarged perivascular spaces in children: differential diagnosis

Congress:

ECR 2018

Poster Number:

C-1499

Type:

Scientific Exhibit

Keywords:

CNS, Neuroradiology brain, CT, MR, Education, Cerebrospinal fluid

Authors:

T. V. P. Morais¹, C. T. F. Perry da Câmara¹, C. Pinheiro¹, M. C. Diogo², C. Conceição¹; ¹Lisbon/PT, ²Vienna/AT

DOI:

10.1594/ecr2018/C-1499

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-1499

Fig. 1: Perivascular Space

Fig. 2: Giant perivascular space, Axial T2.

Fig. 3: Giant perivascular space. Coronal T2.

Fig. 6: Neoplasm (DNET). Coronal T2.

Aims and objectives

Perivascular spaces (PVS) are normal anatomical variants that manifest as frequent incidental findings in brain imaging. Enlarged PVS are benign expansions of the fluid compartments that normally surround the blood vessels as they penetrate through the substance of the brain. They are generally asymptomatic, but may serve as a marker for underlying pathologic processes. When presenting with classic characteristics - along perforating vessels and preponderance in the basal ganglia, centrum semiovale, and midbrain - these are readily identifiable. However, cases with atypical imaging features may...

Methods and materials

Pictorial review with illustrative CT and MR cases of classic, atypical and pathological PVS. Our department’s Neuroradiology database was searched for educational examples of dilated PVS including normal variants, pathological variants and metabolic conditions, as well as typical differential diagnosis.

Results

The cases presented in the figures display includenon-pathologic PVS, usually visualized in MRI as small, round images with intensity similar to liquor, that do not enhance with contrast material with the surrounding brain parenchyma generally showing normal signal intensity. Occasionally, PVS appear markedly enlarged, cause mass effect, and assume bizarre cystic configurations that may be misinterpreted as other pathologic processes. The genetic/metabolic diseases are a important cause of pathologic PVS in the pediatric population, and in this cases the clinical/imaging correlation is essential. The mucopolysaccharidoses...

Conclusion

PVS are frequent incidental findings. Differential diagnosis varies widelywith particular emphasis on the pediatric age for genetic / metabolic diseases. It is essential that the Neuroradiologists are aware of this in order to make the correct diagnosis.

Personal information

References

96 Normal 0 21 false false false PT X-NONE X-NONE 1. Kwee, R.; Kwee, T.; “Virchow-Robin Spaces at MR Imaging”; RadioGraphics 2007; 27:1071–1086. 2.Naidich; Castillo, M; Cha, S; “Imaging of the Brain-Saunders”; Saunders Elsevier; 1st edition; 2012. 96 Normal 0 21 false false false PT X-NONE X-NONE