Department of Neuroradiology, Hospital Dona Estefânia e Hospital São José, Centro Hospitalar de Lisboa Central, Lisboa
Department of Musculoskeletal and Neuroradiology, Vienna, Austria
- European Congress of Radiology (ECR), 28 Fevereiro - 4 Março, Vienna
- Published online: DOI: 10.1594/ecr2018/C-1499
Purpose: Perivascular spaces (PVS) are normal anatomical variants that manifest as frequent incidental findings in brain imaging. When presenting with classic characteristics, these are readily identifiable. However, cases with atypical imaging features may be difficult to diagnose; furthermore, specific pathologies present with characteristic enlarged PVS. The aim of this paper is to present differential diagnosis of enlarged PVS.
Materials and Methods: Pictorial review with illustrative CT and MR cases of classic, atypical and pathological PVS. Our department’s Neuroradiology database was searched for educational examples of dilated PVS including normal variants, pathological variants and metabolic conditions, as well as typical differential diagnosis such an neuroepithelial cysts and infectious processes. Distinguishing features and clues to the diagnosis on MR and CT are discussed.
Results: The following cases are presented: normal and anatomical variants: normal PVS, enlarged PVS in typical locations, giant PVS, choroidal fissure cysts, arachnoid cysts, hippocampal cysts, Cystic tumors : DNET; metabolic / congenital diseases such as hypomelanosis of Ito, Lowe syndrome and mucopolysaccharidosis; and infectious processes, such as neurocysticercosis or cryptococcosis.
Conclusion: PVS are frequent incidental findings. Differential diagnosis varies widely from the same finding in adults, and it is essential that the Neuroradiologist is aware of this in order to make the correct diagnosis.
Palavras Chave: CNS, Neuroradiology brain, CT, MR, Education, Cerebrospinal fluid