Perivascular space semi-automated segmentation (PVSSAS) of 7T images from patients with and without epilepsy following traumatic brain injury

Motivation: Perivascular spaces (PVSs) are small fluid-filled spaces between blood vessels and pia mater. PVSs may appear differently in traumatic brain injury (TBI) patients with and without post-traumatic epilepsy (PTE) due to their role in waste removal. Goal(s): To investigate characteristics of PVSs in PTE relative to TBI without PTE and healthy controls. Approach: A semi-automated workflow for segmenting PVSs was established and applied to images from a 7T MRI study, including 8 TBI patients with PTE, 18 TBI patients without PTE, and 22 healthy controls. Results: Larger median PVS equivalent diameter was observed in TBI, particularly with PTE, suggesting enlarged PVSs in TBI. Impact: Identification of increased median perivascular space equivalent diameter in traumatic brain injury, particularly cases that develop post-traumatic epilepsy as shown in this work, may improve diagnosis and prognostication for post-traumatic epilepsy.