Gd-based Contrast Enhancement of the Perivascular Spaces in the Basal Ganglia

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Author(s)

    • Naganawa Shinji
    • Department of Radiology, Nagoya University Graduate School of Medicine
    • Nakane Toshiki
    • Department of Radiology, Nagoya University Graduate School of Medicine
    • Kawai Hisashi
    • Department of Radiology, Nagoya University Graduate School of Medicine
    • Taoka Toshiaki
    • Department of Radiology, Nagoya University Graduate School of Medicine

Abstract

<p>Purpose: In textbooks, the perivascular space (PVS) is described as non-enhancing after the intravenous administration of gadolinium-based contrast agent (IV-GBCA). We noticed that the PVS sometimes has high signal intensity (SI) on heavily T<sub>2</sub>-weighted 3D-FLAIR (hT<sub>2</sub>-FL) images obtained 4 h after IV-GBCA. The purpose of this study was to retrospectively evaluate the contrast enhancement of the PVS.</p><p>Materials and Methods: In 8 healthy subjects and 19 patients with suspected endolymphatic hydrops, magnetic resonance cisternography (MRC) and hT<sub>2</sub>-FL images were obtained before and 4 h after a single dose of IV-GBCA. No subjects had renal insufficiency. On axial MRC at the level of the anterior commissure (AC)-posterior commissure (PC) line, 1 cm circular regions of interest (ROIs) were drawn centering on the PVS in the bilateral basal ganglia and thalami. Three-millimeter diameter ROIs were set in the cerebrospinal fluid (CSF) of the bilateral ambient cistern. The ROIs on MRC were copied onto the hT<sub>2</sub>-FL images and the SI was measured. The SI ratio (SIR) was defined as SIR<sub>PVS</sub> = SI of PVS/SI of the thalami, and SIR<sub>CSF</sub> = SI of CSF/SI of the thalami. The average of the bilateral values was used for the calculation. The SIR<sub>CSF</sub>, SIR<sub>PVS</sub>, and SI of the thalami were compared between before and 4 h after IV-GBCA.</p><p>Results: The SIR was increased significantly from 1.02 ± 0.37 to 2.65 ± 0.82 in the CSF (<i>P</i> < 0.01) and from 1.20 ± 0.35 to 2.13 ± 1.23 in the PVS at 4 h after IV-GBCA (<i>P</i> < 0.01). The SI of the thalami showed no significant difference.</p><p>Conclusion: The enhancement of the PVS at 4 h after IV-GBCA was confirmed even in subjects without renal insufficiency. It is possible that the GBCA in the blood vessels might have permeated into the cerebrospinal fluid (CSF) space and the PVS. This might be a first step in the imaging evaluation of the glymphatic system (waste clearance system) of the brain.</p>

Journal

  • Magnetic Resonance in Medical Sciences

    Magnetic Resonance in Medical Sciences 16(1), 61-65, 2017

    Japanese Society for Magnetic Resonance in Medicine

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