Perivascular spaces: Meaning in a Radiology Report

Perivascular spaces

Also written as: Virchow-Robin spaces, enlarged perivascular spaces, dilated perivascular spaces

Perivascular spaces are small fluid-filled channels around blood vessels in the brain. They are normal and often become more visible with age.

Seen on: MRI

How it reads in a report

Scattered enlarged perivascular spaces in both basal ganglia and the centrum semiovale, a common finding.

What it means

Small blood vessels that enter the brain from its surface carry a thin sleeve of fluid with them. These sleeves are thought to help clear waste from the brain. On MRI they appear as tiny dots or short lines along the vessels. On every type of image they look just like brain fluid. Most are only a few millimeters across.

When it matters

Some visible spaces are normal at any age, and they become more noticeable as people get older. Large numbers, especially deep in the brain, are linked with high blood pressure and small vessel disease. Radiologists tell them apart from small old strokes by their shape, location and fluid-like signal. They need no treatment. An unusually large one may be checked again on a later scan.

Questions to ask your doctor

Are these spaces normal for my age?
How can you tell these are perivascular spaces and not small strokes?
Is the number of spaces linked to my blood pressure?

General information, not medical advice. What a finding means for you depends on your symptoms, your history and the images themselves, so talk your results through with a doctor.