BACKGROUND AND PURPOSE: The association of perivascular spaces in the centrum semiovale with amyloid accumulation among patients with Alzheimer disease–related cognitive impairment is unknown. We evaluated this association in patients with Alzheimer disease–related cognitive impairment and β-amyloid deposition, assessed with [¹⁸F] florbetaben PET/CT. MATERIALS AND METHODS: MR imaging and [¹⁸F] florbetaben PET/CT images of 144 patients with Alzheimer disease–related cognitive impairment were retrospectively evaluated. MR imaging–visible perivascular spaces were rated on a 4-point visual scale: a score of ≥3 or <3 indicated a high or low degree of MR imaging–visible perivascular spaces, respectively. Amyloid deposition was evaluated using the brain β-amyloid plaque load scoring system. RESULTS: Compared with patients negative for β-amyloid, those positive for it were older and more likely to have lower cognitive function, a diagnosis of Alzheimer disease, white matter hyperintensity, the Apolipoprotein E ε4 allele, and a high degree of MR imaging–visible perivascular spaces in the centrum semiovale. Multivariable analysis, adjusted for age and Apolipoprotein E status, revealed that a high degree of MR imaging–visible perivascular spaces in the centrum semiovale was independently associated with β-amyloid positivity (odds ratio, 2.307; 95% CI, 1.036–5.136; P = .041). CONCLUSIONS: A high degree of MR imaging–visible perivascular spaces in the centrum semiovale independently predicted β-amyloid positivity in patients with Alzheimer disease–related cognitive impairment. Thus, MR imaging–visible perivascular spaces in the centrum semiovale are associated with amyloid pathology of the brain and could be an indirect imaging marker of amyloid burden in patients with Alzheimer disease–related cognitive impairment.

BACKGROUND:. Utilization of a dual-lumen balloon may improve Onyx penetration into isolated dural arteriovenous fistulas (i-DAVFs).OBJECTIVE:. To compar

Objectives: Aging is a major risk factor for many neurological disorders and is associated with dural lymphatic dysfunction. We sought to evaluate the association of aging with the volume of the peri-sinus lymphatic space using contrast-enhanced 3T T1-weighted black-blood magnetic resonance imaging (MRI). Methods: In this retrospective study, 165 presumed neurologically normal subjects underwent brain MRIs for cancer staging between April and November 2018. The parasagittal peri-sinus lymphatic space was evaluated using contrast-enhanced 3D T1-weighted black-blood MRIs, and volumes were measured with semiautomatic method. We compared the volumes of normalized peri-sinus lymphatic spaces between the elderly (≥65 years, n = 72) and non-elderly (n = 93) groups and performed multivariate logistic regression analyses to assess if aging is independently associated with the volume of normalized peri-sinus lymphatic spaces. Results: The normalized peri-sinus lymphatic space volume was significantly higher in the elderly than in the non-elderly (mean, 3323 ± 758.7 mL vs. 2968.7 ± 764.3 mL, p = 0.047). After adjusting the intracranial volume, age age was the strongest factor independently associated with peri-sinus lymphatic space volume (β coefficient, 28.4 (5.7–51.2), p = 0.015) followed by male sex (β coefficient, 672.4 (113.5–1230.8), p = 0.019). Conclusions: We found that the peri-sinus dural lymphatic space volume was higher in the elderly group than in the non-elderly group, and the increased peri-sinus lymphatic space was independently associated with aging. These findings indicate that the peri-sinus lymphatic space may be related with the aging process and lymphatic system dysfunction as well.

Earlier or preprocedural identification of occlusion pathomechanism is crucial for effective endovascular treatment. As leptomeningeal collaterals tend to develop well in chronic ischemic conditions such as intracranial atherosclerosis (ICAS), we investigated whether leptomeningeal collaterals can be a preprocedural marker of ICAS-related large vessel occlusion (ICAS-LVO) in endovascular treatment. A total of 226 patients who underwent endovascular treatment were retrospectively reviewed. We compared the pattern of leptomeningeal collaterals between patients with ICAS-LVO and without. Leptomeningeal collaterals were assessed by preprocedural computed tomography angiography (CTA) and basically categorized by three different collateral assessment methods. Better leptomeningeal collaterals were significantly associated with ICAS-LVO, although they were not independent for ICAS-LVO. When leptomeningeal collaterals were dichotomized to incomplete (<100%) and complete (100%), the latter was significantly more frequent in patients with ICAS-LVO (52.5% versus 20.4%) and remained an independent factor for ICAS-LVO (odds ratio, 3.32; 95% confidence interval, 1.52–7.26; p = 0.003). The area under the curve (AUC) value of complete leptomeningeal collateral supply was 0.660 for discrimination of ICAS-LVO. Incomplete leptomeningeal collateral supply was not likely ICAS-LVO, based on the high negative predictive value (88.6%). Considering its negative predictive value and the independent association between complete leptomeningeal collateral supply and ICAS-LVO, leptomeningeal collaterals could be helpful in the preprocedural determination of occlusion pathomechanism.

Kim JW, et al. Korean J Radiol. 2013 Nov-Dec;14(6):977-980. https://doi.org/10.3348/kjr.2013.14.6.977

Background and Purpose: The association between intracranial aneurysms (IAs) and Marfan syndrome (MFS) is controversial. We aimed to evaluate the prevalence and characteristics of IAs in patients with MFS using brain imaging and compare it with the general population. Methods: Between 2007 and 2020, 118 patients with confirmed MFS who underwent brain imaging were enrolled and classified into 2 groups; IA group versus non-IA. Demographic data were acquired from their medical records, including age, sex, comorbidities, and aortic diseases. Two readers reviewed all brain images independently regarding the presence, morphology, size, and location of IAs. All data were compared between both groups, and IA characteristics in MFS were analyzed using a database of controls with IAs. Results: The prevalence of IAs was 11.9% in patients with MFS. IA group were significantly older in age (44.6±12.1 years in IA versus 36.8±14.0 years in non-IA, P =0.039) and had female predominance (71.4% in IA versus 43.3% in non-IA, P =0.047). All IAs were unruptured, and there was no subarachnoid hemorrhage during the follow-up period (mean; 53.5±43.3 months). The mean diameter of IAs was significantly larger (4.23±1.80 mm in MFS versus 3.04±1.57 mm in control, P =0.004). IAs with MFS were frequently located in the vertebrobasilar artery (33.3% in MFS versus 2.1% in control, P =0.002) and more common in fusiform morphology (13.3% in MFS versus 1.1% in control, P =0.048). Conclusions: This large-cohort study demonstrated a high prevalence and differential features of IAs in MFS, which may support the association between IAs and MFS.