Imaging of enlarged perivascular spaces in Alzheimer’s disease with MRI techniques

Abstract

The development of Alzheimer’s disease (AD) is closely associated with the integrity and function of the perivascular space (PVS). The PVS has essential roles in transporting cerebrospinal fluid and exchanging intracellular substances necessary to clear metabolic waste from the brain. An enlarged PVS (ePVS) is now acknowledged as a major factor in AD development, thus indicating a complex interplay with other pathogenic factors. Herein, we present a detailed examination of the imaging features of PVS, as depicted by various MRI modalities, highlighting how these techniques have advanced understanding of AD pathogenesis. Furthermore, we critically assess the strengths and limitations of these imaging approaches and discuss prospective enhancements that may provide refined insights. Further understanding of the PVS may reveal new diagnostic biomarkers and inform targeted therapeutic approaches, thus improving clinical management for patients with AD.