Effect Of Virchow-Robin Spaces In Early Diagnosed Multiple Sclerosis Patients

Background:-Virchow-Robin space (VRS) are pia-lined extensions of the subarachnoid space surrounding the wall of arteries, arterioles, veins, venules, that enter the brain parenchyma. These spaces are responsible for inflammatory processes within the brain.Objectives:-This study is designed to give an insight on the frequency, location and size of Virchow-Robin spaces in three different regions of the brain in patients of Chinese ethnic group, who are newly diagnosed with multiple sclerosis (MS) and compare the results with age and sex matched healthy controls.Method: - We obtained MRI scans of 50 newly diagnosed MS patients within 3 months of onset and compared the result with 50 healthy controls. MRI was performed with non-contrast 5mm slice thickness, axial Tl-weighted, axial Tl-enhanced, axial T2-weighted, axial FLAIR and sagittal FLAIR followed by post contrast gadolinium intravenous injection scanning.Results: - We observed a greater number of VR Spaces in the supraventricular region with 12 (24%) of 50 MS patients and 10 (20%) of healthy controls who had a frequency of grade 3(>7 VRS). At the midbrain region only 6 (12%) of 50 MS patients and 5 (10%) of healthy controls had the VR Spaces. However, the greatest number of VR Spaces were noted at the region of lenticulostriate arteries to be grade 1(1-3 VRS) in both MS and controls. While the number of dilated VR Space becomes larger in supraventicular region in MS patient (53 VRS) as compared to only 4 VR Spaces in controls. The calculated chi-square value=22.7384 and p value for dilated VR Spaces at the supraventricular region is ＜0.0001.Conclusions: - The result threw more light on the significance of dilated VRS as a marker for MS and can be used as a prognostic tool while the frequency of non dilated VR Spaces is not significant in MS patient than control.