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Hyperintense areas in the intraorbital optic nerve evaluated by T2-weighted magnetic resonance imaging: a glymphatic pathway?

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Abstract

Purpose

The present study aimed to explore the glymphatic pathway in the intraorbital optic nerve (ON) using magnetic resonance imaging (MRI).

Methods

Following conventional MRI examination, a total of 89 outpatients underwent T2-weighted imaging in thin-sliced coronal and sagittal sections. Moreover, three injected cadaver heads were dissected.

Results

In the cadaver specimens, differences in appearance between the central and peripheral parts of the ON were not observed. On the axial T2-weighted MRI performed in the initial examination, the central part of the intraorbital ONs was delineated as a well-demarcated, linear hyperintense area in 19% of patients. On the thin-sliced serial coronal images, the hyperintense areas were identified on both sides in 91% of patients. They were delineated as continuous hyperintense areas in the ONs with an inconsistent appearance even in the same nerve. In 12.4% of patients, the areas were divided into the upper and lower parts by a horizontal septum, while others showed variable morphologies, lacking a septum. On thin-sliced sagittal images, hyperintense areas were identified in 46% of patients.

Conclusion

Hyperintense areas in the intraorbital ON detected on T2-weighted sequences may involve a glymphatic pathway with perivascular spaces of the ON and central retinal artery. These may be collapsed and difficult to identify on surgical and cadaver specimens.

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Acknowledgements

This study did not receive any grant funding.

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Authors and Affiliations

  1. Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan

    Satoshi Tsutsumi & Hisato Ishii

  2. Division of Radiological Technology, Medical Satellite Yaesu Clinic, Tokyo, Japan

    Hideo Ono

Authors
  1. Satoshi Tsutsumi
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  2. Hideo Ono
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  3. Hisato Ishii
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Contributions

ST and HO developed the study project. ST performed cadaver dissection. HO performed examinations using magnetic resonance imaging. HI collected and managed the data. ST and HI analyzed the data. ST wrote the manuscript.

Corresponding author

Correspondence to Satoshi Tsutsumi.

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Conflict of interest

The authors have no conflicts of interest concerning the materials and methods used in this study or the findings presented in this manuscript.

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Tsutsumi, S., Ono, H. & Ishii, H. Hyperintense areas in the intraorbital optic nerve evaluated by T2-weighted magnetic resonance imaging: a glymphatic pathway?. Surg Radiol Anat 43, 1273–1278 (2021). https://doi.org/10.1007/s00276-020-02649-7

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  • DOI: https://doi.org/10.1007/s00276-020-02649-7

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