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

Serhat V Okar1, Fengling Hu2, Russell T Shinohara2

  • 1Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States.

Frontiers in Neuroscience
|April 17, 2023
PubMed
Abstract

Insights

This systematic review explores the causes and progression of MRI-visible perivascular spaces (MVPVS). While several etiologies are proposed, evidence remains limited, hindering their use as reliable biomarkers.

Area of Science:

  • Neurology and Neuroimaging
  • Neuroinflammation and Neurodegeneration

Background:

  • Perivascular spaces are implicated in neurological diseases.
  • Enlarged perivascular spaces (EPVS), or MRI-visible perivascular spaces (MVPVS), are detectable via MRI.
  • Understanding MVPVS etiology and dynamics is crucial for their diagnostic utility as MRI biomarkers.

Approach:

  • A systematic review and meta-analysis were conducted.
  • 140 publications were analyzed for etiopathogenesis and dynamics of MVPVS.
  • A meta-analysis assessed the association between MVPVS and brain atrophy.

Key Points:

  • Proposed etiologies include impaired fluid circulation, arterial changes, brain atrophy, and immune cell accumulation.
  • Meta-analysis found no significant association between MVPVS and brain volume in neuroinflammatory diseases.
  • Temporal evolution of MVPVS appears slow, based on limited studies.

Conclusions:

  • Evidence for MVPVS etiopathogenesis and dynamics is presented.
  • Current data partially support proposed etiologies for MVPVS.
  • Advanced MRI techniques are recommended to further elucidate MVPVS development and progression for biomarker implementation.
Keywords:
Virchow-Robin spacesbiomarkerenlarged perivascular spacesetiologyetiopathogenesismagnetic resonance imagingmeta-analysissystematic review

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