Edinburgh Imaging

08 Apr 20. Featured Paper

Relationship between venules & perivascular spaces in sporadic small vessel diseases.

Link to paper on AHA Journals, Stroke



Angela C.C. Jochems, Gordon W. Blair, Michael S. Stringer, Michael J. Thrippleton, Una Clancy, Francesca M. Chappell, Rosalind Brown, Daniela Jaime Garcia, Olivia K.L. Hamilton, Alasdair G. Morgan, Ian Marshall, Kirstie Hetherington, Stewart Wiseman, Tom MacGillivray, Maria C. Valdés-Hernández, Fergus N. Doubal, Joanna M. Wardlaw



Background & purpose: Perivascular spaces (PVS) around venules may help drain interstitial fluid from the brain.

We examined relationships between suspected venules & PVS visible on brain magnetic resonance imaging.

Methods: We developed a visual venular quantification method to examine the spatial relationship between venules & PVS.

We recruited patients with lacunar stroke or minor nondisabling ischemic stroke & performed brain magnetic resonance imaging & retinal imaging.

We quantified venules on gradient echo or susceptibility-weighted imaging & PVS on T2-weighted magnetic resonance imaging in the centrum semiovale & then determined overlap between venules & PVS.

We assessed associations between venular count & patient demographic characteristics, vascular risk factors, small vessel disease features, retinal vessels, & venous sinus pulsatility.

Results: Among 67 patients (69% men, 69.0±9.8 years), only 4.6% (range, 0%–18%) of venules overlapped with PVS.

Total venular count increased with total centrum semiovale PVS count in 55 patients after accounting for venule-PVS overlap (β=0.468 [95% CI, 0.187–0.750]) & transverse sinus pulsatility (β=0.547 [95% CI, 0.309–0.786]) & adjusting for age, sex, & systolic blood pressure.

Conclusions: Despite increases in both visible PVS & suspected venules, we found minimal spatial overlap between them in patients with sporadic small vessel disease, suggesting that most magnetic resonance imaging-visible centrum semiovale PVS are periarteriolar rather than perivenular.