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Conforti R, Capasso R, Franco D, Russo C, Rinaldi FO, Pezzullo G, Coluccino S, Brunese MC, Caiazzo C, Caranci F, Tortora F. Giant Tumefactive Perivascular Space: Advanced Fusion MR Imaging and Tractography Study-A Case Report and a Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13091602. [PMID: 37174993 PMCID: PMC10177987 DOI: 10.3390/diagnostics13091602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Perivascular spaces (PVSs) are small extensions of the subpial cerebrospinal space, pial-lined and interstitial fluid-filled. They surround small penetrating arteries, and veins, crossing the subarachnoid space to the brain tissue. Magnetic Resonance Imaging (MRI) shows a PVS as a round-shape or linear structure, isointense to the cerebrospinal fluid, and, if larger than 1.5 cm, they are known as giant/tumefactive PVSs (GTPVS) that may compress neighboring parenchymal/liquoral compartment. We report a rare asymptomatic case of GTPVS type 1 in a diabetic middle-aged patient, occasionally discovered. Our MRI study focuses on diffusion/tractography and fusion imaging: three-dimensional (3D) constructive interference in steady state (CISS) and time of fly (TOF) sequences. The advanced and fusion MR techniques help us to track brain fiber to assess brain tissue compression consequences and some PVS anatomic features as the perforating arteries inside them.
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Affiliation(s)
- Renata Conforti
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Raffaella Capasso
- Department of Radiology, CTO Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy
| | - Donatella Franco
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Carmela Russo
- Unit of Neuroradiology, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, AORN, 80129 Naples, Italy
| | - Fabio Oreste Rinaldi
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giovanna Pezzullo
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Simone Coluccino
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Maria Chiara Brunese
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy
| | - Corrado Caiazzo
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy
| | - Ferdinando Caranci
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Fabio Tortora
- Unit of Neuroradiology, Department of Advanced Biomedical Sciences, Federico II University, 80138 Naples, Italy
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Ayyildiz V, Koksal A, Taydas O, Ogul H. Contribution of advanced MRI to the diagnosis of giant tumefactive perivascular spaces. Acta Radiol 2021; 63:1554-1562. [PMID: 34839718 DOI: 10.1177/02841851211047240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Giant tumefactive perivascular spaces (PVSs) are uncommon benign cystic lesions. They can imitate cystic neoplasms. PURPOSE To evaluate the contribution of advanced neuro magnetic resonance imaging (MRI) techniques in the diagnosis of giant tumefactive PVSs and to further characterize these unusual cerebral lesions. MATERIAL AND METHODS The MRI scans of patients with tumefactive PVS diagnosed between 2010 and 2019 were retrospectively reviewed. All imaging studies included three plane conventional cerebral MRI sequences as well as precontrast 3D T1 MPRAGE, post-gadolinium 3D T1 acquisitions, sagittal plane 3D T2 SPACE, diffusion-weighted imaging, and time-of-flight (TOF) angiography. Some patients received perfusion MR, MR spectroscopy, diffusion tensor imaging (DTI), and contrast-enhanced TOF MR angiography. RESULTS A perforating vessel was demonstrated in 16 patients (66.7%) by TOF imaging. In four patients, there were intracystic vascular collaterals on contrast-enhanced TOF MR angiography. Septal blooming was observed in four patients in susceptibility-weighted imaging. On perfusion MR, central hyperperfusion was observed in four patients, and peripheral hyperperfusion was observed in one patient. On MR spectroscopy, choline increase was observed in two patients, and there was a lactate peak in three patients, and both a choline increase and lactate peak in one patient. On DTI, there was fiber distortion in five patients and fiber deformation in one patient. CONCLUSION Advanced MRI techniques and 3D volumetric high-resolution MRI sequences can provide a valuable contribution to the diagnosis and can be successfully used in the management of these lesions.
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Affiliation(s)
- Veysel Ayyildiz
- Department of Radiology, Medical Faculty, Suleyman Demirel University, Isparta, Turkey
| | - Ali Koksal
- Bayindir Private Hospital, Ankara, Turkey
| | - Onur Taydas
- Department of Radiology, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Hayri Ogul
- Department of Radiology, Medical Faculty, Duzce University, Duzce, Turkey
- Anesthesiology Clinical Research Office, Ataturk University, Erzurum, Turkey
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Capasso R, Negro A, Cirillo S, Iovine S, Puoti G, Cirillo M, Conforti R. Large anterior temporal Virchow–Robin spaces: Evaluating MRI features over the years—Our experience and literature review. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2020. [DOI: 10.1177/2514183x20905252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dilated Virchow–Robin spaces (VRSs) are expansions of the normal perivascular spaces with a short axis greater than 2 mm or, according to some authors, greater than 3 mm. They are usually documented at the basal ganglia, at the convexity white matter (WM) and centrum semiovale, and at the mesencephalon. The anterior temporal WM is a recently described preferential location for large (≥5 mm) VRSs. The aim of our study was to evaluate the magnetic resonance imaging (MRI) features and their modifications during a long-term follow-up period (≥24 months) of the anterior temporal VRSs with a retrospective analysis among all brain MRI studies performed at our institution between January 2010 and January 2017. In our study, the presence and the stability of characteristic MRI features certainly increased our diagnostic confidence allowing us to continue conservative approach while the surrounding signal change, as reported in the literature, should not in itself prompt alternative diagnoses to be entertained.
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Affiliation(s)
- Raffaella Capasso
- Neuroradiology Unit PO CTO, University of Campania Luigi Vanvitelli, Viale Colli Aminei 21, Napoli, Italy
| | - Alberto Negro
- Neuroradiology Unit PO, Ospedale del Mare, ASL Napoli 1, Via Enrico Rossi, Napoli, Italy
| | - Sossio Cirillo
- Neuroradiology Unit PO CTO, University of Campania Luigi Vanvitelli, Viale Colli Aminei 21, Napoli, Italy
| | - Silvia Iovine
- Dipartimento di Medicina di Precisione, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Gianfranco Puoti
- Dipartimento di Scienze Mediche e Chirurgiche Avanzate (DAMSS), University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Mario Cirillo
- Dipartimento di Scienze Mediche e Chirurgiche Avanzate (DAMSS), University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Renata Conforti
- Dipartimento di Medicina di Precisione, University of Campania Luigi Vanvitelli, Napoli, Italy
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Kwee RM, Kwee TC. Tumefactive Virchow-Robin spaces. Eur J Radiol 2019; 111:21-33. [DOI: 10.1016/j.ejrad.2018.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/01/2018] [Accepted: 12/11/2018] [Indexed: 12/11/2022]
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Conforti R, Sardaro A, Negro A, Caiazzo G, Paccone A, De Micco R, Cirillo S, Tessitore A. Dilated Virchow-Robin space and Parkinson's disease: A case report of combined MRI and diffusion tensor imaging. Radiol Case Rep 2018; 13:871-877. [PMID: 29988793 PMCID: PMC6031236 DOI: 10.1016/j.radcr.2018.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/10/2018] [Accepted: 05/23/2018] [Indexed: 12/03/2022] Open
Abstract
In this manuscript we report the case of a 69-year-old female patient, who suffers from Parkinson's disease (PD) with a dilated Virchow-Robin space (dVRS) on the left anterior perforated substance. During a magnetic resonance imaging examination, the presence of a dVRS was discovered on the left anterior perforated substance. Subsequently, the patient has been subjected to further investigation of magnetic resonance imaging and diffusion tensor imaging (DTI). The DTI data of our PD patient showed increased peak frequency of left fractional anisotropy and decreases in the distribution of Mean Diffusivity(MD) with changes in the fiber density compared to the normal contralateral tract. We hypothesize that the DTI changes are due to dVRS. In the text a review of the recent literature on the presence of dVRSs, located in mono and bilateral seat, in patients with PD is reported, explaining its possible implications on disease progression, cognitive decline, and worsening of symptoms.
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Affiliation(s)
- Renata Conforti
- Università degli Studi della Campania Luigi Vanvitelli, Section of Neuroradiology, viale Colli Aminei 21, Napoli 80131, Italy
| | - Angela Sardaro
- Università degli Studi della Campania Luigi Vanvitelli, piazza Miraglia 2, Napoli 80138, Italy
| | - Alberto Negro
- Università degli Studi della Campania Luigi Vanvitelli, Section of Neuroradiology, viale Colli Aminei 21, Napoli 80131, Italy
| | - Giuseppina Caiazzo
- MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, piazza Miraglia 2, Napoli 80138, Italy
| | - Antonella Paccone
- MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, piazza Miraglia 2, Napoli 80138, Italy
| | - Rosita De Micco
- Università degli Studi della Campania Luigi Vanvitelli, Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, piazza Miraglia 2, Napoli 80138, Italy
| | - Sossio Cirillo
- Università degli Studi della Campania Luigi Vanvitelli, Section of Neuroradiology, viale Colli Aminei 21, Napoli 80131, Italy
| | - Alessandro Tessitore
- Università degli Studi della Campania Luigi Vanvitelli, Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, piazza Miraglia 2, Napoli 80138, Italy
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Cacciola A, Calabrò RS, Costa A, Naro A, Milardi D, Bruschetta D. Enlarged Virchow-Robin Spaces in A Young Man: A Constrained Spherical Deconvolution Tractography Study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88:319-324. [PMID: 29083338 DOI: 10.23750/abm.v88i3.5181] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/02/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Virchow-Robin spaces are mainly located along the path of the lenticulo-striate arteries in the basal ganglia through the anterior perforate substance, and can be found both in normal subjects, as a rare phenomenon, and in patients with different diseases. We report a case of a healthy young man with unilateral enlarged Virchow-Robin spaces in the left capsule-lenticulostriate area. Aim of this case report is to show the potential of probabilistic Constrained Spherical Deconvolution (CSD) tractography in showing abnormal diffusion tensor imaging and tractography of the anterior thalamic tracts caused by mass effect from adjacent enlarged Virchow-Robin spaces. METHODS The study was performed with a 3T magnetic resonance imaging (MRI) scanner (Achieva, Philips Healthcare, Best, Netherlands); equipped with a 32-channel SENSE head coil. Diffusion Weighted Images were analyzed by using CSD, a fast computation method that overcomes major limitations of Diffusion Tensor Imaging allowing reliable estimation of one or more fiber orientations in the presence of intravoxel orientational heterogeneity. RESULTS Tractography showed increased Fractional Anisotropy and reduced Apparent Diffusion Coefficient values, a displacement and compression of the anterior thalamic projections by part of the enlarged VRS, and a decrease of white matter fibers in the left side in comparison to the right one. CONCLUSIONS We report on a case of a healthy individual with unilateral dilated VRS in the capsulo-lenticulostriatal area, proving the utility of diffusion MRI and tractography in understanding the abnormal neuroanatomy of this particular condition.
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Affiliation(s)
- Alberto Cacciola
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124 Messina.
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Conforti R, Cirillo M, Sardaro A, Caiazzo G, Negro A, Paccone A, Sacco R, Sparaco M, Gallo A, Lavorgna L, Tedeschi G, Cirillo S. Dilated perivascular spaces and fatigue: is there a link? Magnetic resonance retrospective 3Tesla study. Neuroradiology 2016; 58:859-66. [PMID: 27423658 DOI: 10.1007/s00234-016-1711-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 05/31/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Fatigue (F) is a common, inexplicable, and disabling symptom in multiple sclerosis (MS) patients. The purpose of this study was to evaluate a possible correlation between fatigue and morpho-volumetric features and site of dilated perivascular spaces (dPS), visible on 3T magnetic resonance (MR) in fatigued multiple sclerosis patients (FMS). METHODS We studied 82 relapsing remitting (RR) FMS patients and 43 HC, matched for age, sex, and education. F was assessed by the Fatigue Severity Scale (FSS). To evaluate a possible correlation between degree of F and characteristics of dPS, patients were divided in two groups: more (mFMS) (FSS ≥ 5; n = 30) and less fatigued (lFMS) (FSS ≥ 4; n = 52), compared to a matched healthy control (HC) subject group. The MR study was performed with 3T scanner by SpinEcho T1, Fast-SpinEcho DP-T2, FLAIR, and 3D FSPGR T1 sequences. dPS volumes were measured with Medical Image Processing Analysis and Visualization (MIPAV); Global Cerebral Atrophy (GCA), expressed as Brain Parenchymal Fraction (BPF), was assessed by FSL SIENAX. RESULTS The t test showed significantly increased dPS number (p = 0.021) in FMS patients (mFMS p = 0.0024 and lFMS p = 0.033) compared to HC. Pearson correlation revealed a significant correlation between dPS number and FSS (r = 0.208 p = 0.051). Furthermore, the chi-squared test confirms the intragroup (HC, mFMS, lFMS) differences about dPS location (p = 0.01) and size (p = 0.0001). CONCLUSION Our study confirms that PS in MS patients presents with different volumetric and site characteristics as compared to HC; moreover, F severity significantly correlates with dPS number, site, and size.
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Affiliation(s)
- Renata Conforti
- Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy
| | - Mario Cirillo
- Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy
| | - Angela Sardaro
- Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy.
| | - Giuseppina Caiazzo
- MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Alberto Negro
- Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy
| | - Antonella Paccone
- MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Rosaria Sacco
- Department of Neurology, Second University of Naples, Naples, Italy
| | | | - Antonio Gallo
- Department of Neurology, Second University of Naples, Naples, Italy
| | - Luigi Lavorgna
- Department of Neurology, Second University of Naples, Naples, Italy
| | | | - Sossio Cirillo
- Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy
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Conforti R, Cirillo M, Saturnino PP, Gallo A, Sacco R, Negro A, Paccone A, Caiazzo G, Bisecco A, Bonavita S, Cirillo S. Dilated Virchow–Robin spaces and multiple sclerosis: 3 T magnetic resonance study. LA RADIOLOGIA MEDICA 2013; 119:408-14. [DOI: 10.1007/s11547-013-0357-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 01/30/2013] [Indexed: 10/26/2022]
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