Use of medical imaging techniques as part of the evidence for the presence of meningeal lymphatics

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The lymphatic system is an integral part of the microcirculatory bed, which structurally and functionally complements the venous bed. It ensures constancy in the internal environment of the human body and performs transport, barrier, lymphopoietic, and immune functions, playing an exceptional role in the metabolism and cleansing of the body’s cells and tissues from metabolic products.

The researchers assume that the meningeal lymphatic vessels (MLVs) may be involved in the process of cleansing the brain from metabolic products. Today, the problem of proving the existence of MLVs is a key one in understanding the anatomy and physiology of processes in the brain as a whole. Medical imaging techniques make it possible to prove the presence of MLVs. The paper analyzes the methods that are currently more frequently used to determine MLVs.

Experimental medical imaging techniques allow us to conduct researches, by confirming or ruling out the scientific theories put forward. These methods are further evidence-based medicine.

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作者简介

V. Ryazanov

Saint Petersburg State Pediatric Medical University of the Ministry of Health of Russia

编辑信件的主要联系方式.
Email: val9126@mail.ru

Doctor of Medical Sciences, Associate Professor

俄罗斯联邦, Saint Petersburg

E. Yukhno

S.M. Kirov Military Medical Academy

Email: val9126@mail.ru

Candidate of Medical Sciences

俄罗斯联邦, Saint Petersburg

V. Kutsenko

Saint Petersburg State Pediatric Medical University of the Ministry of Health of Russia

Email: val9126@mail.ru

Candidate of Medical Sciences

俄罗斯联邦, Saint Petersburg

G. Sadykova

Saint Petersburg State Pediatric Medical University of the Ministry of Health of Russia

Email: val9126@mail.ru

Candidate of Medical Sciences

俄罗斯联邦, Saint Petersburg

A. Libert

Saint Petersburg State Pediatric Medical University of the Ministry of Health of Russia

Email: val9126@mail.ru
俄罗斯联邦, Saint Petersburg

S. Menshikova

Saint Petersburg State Pediatric Medical University of the Ministry of Health of Russia

Email: val9126@mail.ru
俄罗斯联邦, Saint Petersburg

P. Seliverstov

S.M. Kirov Military Medical Academy

Email: val9126@mail.ru

Candidate of Medical Sciences, Associate Professor

俄罗斯联邦, Saint Petersburg

参考

  1. Albayram M.S., Smith G., Tufan F. et al. Non-invasive MR imaging of human brain lymphatic networks with connections to cervical lymph nodes. Nat Commun. 2022; 13 (1): 203. doi: 10.1038/s41467-021-27887-0
  2. Buccellato F.R., D’Anca M., Serpente M. et al. The Role of Glymphatic System in Alzheimer’s and Parkinson’s Disease Pathogenesis. Biomedicines. 2022; 10 (9): 2261. doi: 10.3390/biomedicines10092261
  3. Dai W., Yang M., Xia P. et al. A functional role of meningeal lymphatics in sex difference of stress susceptibility in mice. Nat Commun. 2022; 13 (1): 4825. doi: 10.1038/s41467-022-32556-x
  4. Jacob L., de Brito Neto J., Lenck S. et al. 3D-imaging reveals conserved cerebrospinal fluid drainage via meningeal lymphatic vasculature in mice and humans. BioRxiv. 2022; 2022.01.13.476230. doi: 10.1101/2022.01.13.476230
  5. Li X., Qi L., Yang D. et al. Meningeal lymphatic vessels mediate neurotropic viral drainage from the central nervous system. Nat Neurosci. 2022; 25 (5): 577–87. doi: 10.1038/s41593-022-01063-z
  6. Noé F.M., Marchi N. Central nervous system lymphatic unit, immunity, and epilepsy: Is there a link? Epilepsia Open. 2019; 4 (1): 30–9. doi: 10.1002/epi4.12302
  7. Olate-Briones A., Escalona E., Salazar. C. et al. The meningeal lymphatic vasculature in neuroinflammation. FASEB J. 2022; 36 (5): e22276. doi: 10.1096/fj.202101574RR
  8. Scholkmann F., Restin T. Meningeal lymphatic vessels in the human head: Examples of in vivo visualization with high-resolution 3T MRI. Matters: online. 2020. doi: 10.5167/uzh-195289
  9. Shimada R., Tatara Y., Kibayashi K. (2022) Gene expression in meningeal lymphatic endothelial cells following traumatic brain injury in mice. PLoS One. 2022; 17 (9): e0273892. doi: 10.1371/journal.pone.0273892
  10. Zhou C., Ma L., Xu H. et al. Meningeal lymphatics regulate radiotherapy efficacy through modulating anti-tumor immunity. Cell Res. 2022; 32 (6): 543–54. doi: 10.1038/s41422-022-00639-5

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2. Fig. 1. Visualization of the meningeal lymphatics on an MRI. The picture shows MR-images of the brain – frontal (a and b) and axial (c) (the MRI-modes are listed above): a – the superior sagittal sinus (SSS) is visualized as a hyper-intensive triangle-shaped formation (white arrows); b, c – there is no visualization of the SSS, but the hyper-intensive signals of the supposed meningeal lymphatics are clearly visible as dots surrounding the SSS (yellow arrows) [8]

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3. Fig. 2. Phantom studies of head and neck structures using 3D-T2 FLAIR (а–с) and the corresponding MP-tomogram (d) in the frontal axis: а, b – albumin concentration in the desired structures is significantly increased, confirming their structural similarity to lymphatic vessels; d – the green pointer indicates the meningeal lymphatics above and the cervical lymph node (cLN) below [1]

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4. Fig. 3. iDISCO-LFSM imaging of cranial cerebrospinal fluid tracer drainage: a – schematic of the experimental workflow; b–d – fluorescent glow of the desired structures along the structures of the brain; e – 3D-schematic of the lateral view of the head and neck [4]

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5. Fig. 4. Schematic workflow of the meningeal lymphatics 3D-mapping using MRI [4]

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6. Fig. 5. Model of the 3D-mapping of the meningeal lymphatics; dorsolateral vessels group, posteriolateral view [4]

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