血管读片周围间隙.pptxVIP

血管读片主班：江远亮副班：刘崎教授CASEA 57-year-old womanrecurrent episodes of clumsiness of her left hand and frequent headaches since 2001unspecific unilateral hyperintensities in her left cerebral hemisphere had been noted at a previous MR examination in 2004other medical history was unremarkableCoronal T2WIAxial fluid-attenuated inversion recoveryDiffusion-weighted single-shot echo-planarMR imageVirchow-Robin Spacesat MR ImagingAnatomyVR spaces surround the walls of arteries, arterioles,veins, and venules as they course from the subarachnoid space through the brain parenchymaElectron microscopy and tracer studies have given insight into the location of VR spaces and clarified that the subarachnoid space does not communicate directly with the VR spacesPrevalenceSmall VR spaces (2 mm) appear in all age groups. With advancing age, VR spaces are found with increasing frequency and larger apparent size (2 mm)Dilated VR SpacesⅠ（2mm）、 Ⅱ（2-3mm）、 Ⅲ（3mm）The mechanisms underlying expanding VR spaces are still unknowndVRS is an indicator of cerebral small vessel diseases such as leukoaraiosis and lacune.Locations and MorphologyDilated VR spaces typically occur in three characteristic locationstype Itype IItype IIIThe first type (type I) is frequently seen on MR images and appears along the lenticulostriate arteries entering the basal ganglia through the anterior perforated substanceThe second type (type II) can be found along the path of the perforating medullary arteries as they enter the cortical gray matter over the high convexities and extend into the white matterThe third type (type III) appears in the midbrain.In the lower midbrain, VR spaces at the pontomesencephalic junction surround the penetrating branches of the collicular and accessory collicular arteriesLocations and Morphologywell-defined oval,rounded, or tubular structures, smooth margins, commonly appear bilaterally, and usually measure 5 mm or lessAppearance at MR ImagingVisually, the signal intensities of the VR spaces are