PMID: 11901003Mar 20, 2002Paper

Sandlike appearance of Virchow-Robin spaces in early multiple sclerosis: a novel neuroradiologic marker.

AJNR. American Journal of Neuroradiology
Anat Achiron, Meir Faibel

Abstract

The distinctive hyperintensity of multiple sclerosis (MS) lesions on T2-weighted brain MR images is well recognized. However, Virchow-Robin spaces (VRSs), especially in early MS, have not been described. Our purpose was to determine the frequency of VRSs in recent-onset MS. Brain MR imaging was performed in 71 patients (mean age, 26.8 years; range, 20-41 years; 47 women, 24 men) within 3 months of MS onset. Proton density-, T2-, and T1-weighted images were obtained. Age-and sex-matched control subjects (mean age, 27.2 years; range, 22-41 years; 38 women, 22 men) who underwent brain MR imaging as a part of headache evaluation, and findings that were interpreted as normal served as controls. On high-convexity images (axial sections above the upper corpus callosum border), VRSs were identified as small (<2-mm diameter) sandlike areas isointense to CSF. VRSs were graded 0-3. VRSs were visualized in high-convexity white matter in 55% of patients and 7% of control subjects (P <.001). In patients, 15% of VRSs were grade 1 (fewer than four), 23% were grade 2 (four to seven), and 62% were grade 3 (more than seven). In control subjects, all identified VRSs were grade 1. Among patients with and those without VRSs, age at onset, neurologic...Continue Reading

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