Virchow-Robin spaces on magnetic resonance images: normative data, their dilatation, and a review of the literature

• Published in: Neuroradiology Vol. 48; no. 10; pp. 745 - 754
• Main Authors: Groeschel, Samuel, Chong, Wui Khean, Surtees, Robert, Hanefeld, Folker
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.10.2006; Springer Nature B.V
• Subjects: Adolescent; Adult; Anatomy & physiology; Biological and medical sciences; Brain; Brain - blood supply; Brain - pathology; Brain - physiopathology; Brain Diseases - pathology; Brain Diseases - physiopathology; Case-Control Studies; Cerebrovascular Circulation - physiology; Child; Child, Preschool; Dilatation, Pathologic - pathology; Electrodiagnosis. Electric activity recording; Humans; Infant; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Medical sciences; Microcirculation - physiology; Miscellaneous. Technology; Nervous system; Neurosciences; NMR; Nuclear magnetic resonance; Pediatrics; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Reference Values; Nervous system diseases; Radiodiagnosis; Dilatation; MRI; Magnetic resonance; Review; Perivascular spaces; Nuclear magnetic resonance imaging; Virchow-Robin spaces
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-006-0112-1

Virchow-Robin spaces (VRS) are perivascular spaces in the brain and can be visualized on magnetic resonance images (MRI). We attempt to provide a better understanding of the significance of VRS for pathological and physiological processes by reviewing the literature, presenting normative data for the first time, and proposing a definition for the dilatation of the VRS on MRI that is based on shape rather than size. We evaluated the VRS in 125 healthy subjects (age range 1-30 years) using high-resolution 3D images, and in 36 patients (age range 2-16 years) with normal MRI, using routine clinical sequences. VRS were visible in all high-resolution images of the 125 healthy subjects. Two of them revealed dilated VRS, giving a prevalence of 1.6%. VRS could be visualized in 29 (80%) of the 36 paediatric clinical scans; none was dilated. It was demonstrated that the visibility of VRS on MRI is sequence-dependent. From the results of this study and the literature on the nature and pathology of VRS, we conclude that VRS on MR images of healthy individuals are normal findings, even if they are dilated. A judgement on whether dilated VRS in an individual patient is a normal variant or part of a disease process can be made by taking into account the appearance of the adjacent tissue on MRI and the clinical context.