血管周围间隙的MR表现

目的分析总结血管周围间隙发生部位及MRI表现,提高其诊断符合率。方法随机选择磁共振检查显示有血管周围间隙的病例130例;其中16例进行了MR增强扫描,21例行弥散加权成像;19例行CT检查,4例行CT增强扫描。结果130例病例血管周围间隙均为双侧多发,呈圆形或椭圆形、点状、条状或线状,边界清晰锐利,条形或线形的血管周围间隙多成簇出现,且沿着纤维走行方向排列。发生部位包括前连合两侧(97.69%,127/130)、近大脑凸面的半卵圆中心(85.38%,111/130)、脑干大脑脚处(37.69%,49/130)、极外囊(23.85%,31/130),小脑齿状核旁白质仅见1例。MRI不同序列显示间隙信号与脑脊液信号完全一致,增强扫描无强化征象。随访病例均未发现明显变化。小血管周围间隙见于任何年龄组的所有130例病例,而17例可见大血管周围间隙间隙,其中3例有轻度占位效应。结论血管周围间隙可见于任何年龄,好发生于前连合两侧、近大脑凸面半卵圆中心、脑干大脑脚、极外囊,呈条形或线形、圆形或卵圆形,边界清晰锐利,绝大多数无占位效应,MR成像各种序列显示与脑脊液信号完全一致。

Perivascular spaces: MR appearance

Objective To analyze the MR appearance of perivascular spaces. Methods MR images of 130 cases of perivascular spaces were selected randomly in this study. Among them, 16 cases were undergone enhanced MRI, 21 undergone diffusion weighted imaging; 19 cases studied with CT, and 4 were with enhanced CT. Results Multiple perivascular spaces were found in cerebral and cerebellar hemispheres bilaterally, shaped round or oval, punctual, strip or linear with clear borderline in all 130 cases. The lesions shaped strip or linear usually clustered and arrayed along the white matter fasciculi. Their location was consistently in around anterior commissure (97.69%, 127/130), centrum semiovale near high-convexity of the cerebrum (85.38%, 111/130), cerebral peduncles (37.69%, 49/130), extreme capsules (23.85%, 31/130), and only one case's lesion was in cerebellar whiter matter. The signal of perivescular spaces was isointense relative to CSF on all MR pulse sequences, and with no enhancement after injection of contrast agent. No change was noted on follow-up MRI. Mild spaces were identified in all cases of all ages, and large spaces were found in 17 cases, 3 of them had mild mass effect. Conclusion Perivascular spaces can be identified in all persons of all ages, and usually locate in such as around anterior commissure, centrum semiovale near high-convexity of the cerebrum, cerebral peduncles, extreme capsules. They are round or oval, punctual, strip or linear, and have no mass effect, usually are isointense relative to CSF on all MR pulse sequences.