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Abstract Perivascular spaces (PVS) are central to cerebrospinal fluid (CSF)-interstitial fluid (ISF) exchange in the brain, yet their brain-wide organization and in vivo accessibility remain poorly resolved due to limited spatial resolution and contrast specificity of existing imaging approaches. Prior gadolinium (Gd)-enhanced MRI studies demonstrate global tracer distribution but yield spatially diffuse signals that do not resolve PVS at the level of individual vessels. Here we introduce an ultra-high-resolution dual-contrast MRI framework that enables vessel-resolved mapping of PVS across the whole brain in vivo. This approach combines ultra-high-field imaging, an implantable radiofrequency coil for enhanced local sensitivity, and intraventricular Gd delivery to achieve sufficient contrast and spatial specificity for detecting vessel-associated perivascular signal. Using this framework, we show that PVS are hierarchically organized along vascular trees, extending from major surface arteries into deep cortical and subcortical regions. Signal patterns along arterial branches and junctions indicate that PVS follows vascular topology. Quantitative analysis reveals that only a subset of penetrating vessels (∼6%) exhibits detectable PVS signal, indicating heterogeneous organization across vascular networks independent of vessel caliber. Widespread detection of PVS, including in the hippocampus, further demonstrates that ventricularly delivered tracers access a distributed, vessel-associated perivascular network in vivo . These results establish an anatomical framework for mapping perivascular transport pathways across the brain, bridging global tracer imaging with vessel-resolved organization, and enabling investigation of how vascular architecture and fluid dynamics shape CSF-ISF exchange.
Zhou et al. (Tue,) studied this question.