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

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Multiple sclerosis (MS) lesions on T2-weighted brain MRI are well-known.
• Virchow-Robin spaces (VRSs) in early MS have not been previously described.

Purpose of the Study:

• To determine the frequency of VRSs in patients with recent-onset MS.
• To investigate VRSs as a potential early indicator in MS.

Main Methods:

• Brain MRI was performed on 71 recent-onset MS patients and 50 age/sex-matched controls.
• VRSs were identified on high-convexity images and graded.
• Proton density-, T2-, and T1-weighted images were utilized.

Main Results:

• VRSs were found in 55% of MS patients versus 7% of controls (P <.001).
• In MS patients, VRSs were predominantly grade 3 (more than seven).
• No significant differences in age, disability, or symptoms were noted between MS patients with and without VRSs.

Conclusions:

• VRSs are significantly more frequent in recent-onset MS patients compared to controls.
• The sandlike appearance of VRSs may serve as a neuroradiologic marker for early MS inflammation.