{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:45:05Z","timestamp":1790808305022,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,2]],"date-time":"2022-10-02T00:00:00Z","timestamp":1664668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>Previous studies have proposed multiple parallel channels for waste clearance from the brain, though many gaps remain in our understanding of these systems. In this study, we examined periarterial fluid drainage around intracranial and extracranial segments of the internal carotid arteries (ICAs) from the brain into the cervical lymph nodes using a noninvasive and clinical\u2010based method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty\u2010one subjects (45 females, aged 15\u201080\u00a0years old) with nonlesioned epilepsy underwent high\u2010resolution 3\u2010dimensional T2\u2010weighted fluid\u2010attenuated inversion recovery (FLAIR) MRI. We utilized a noninvasive and clinical\u2010based method with a manual semiautomated approach to characterize the periarterial lymphatic system's maximum thickness and signal intensities along the ICAs using high\u2010resolution 3\u2010dimensional FLAIR imaging. We conducted group comparisons and correlation analyses to investigate sex\u2010 and age\u2010based trends. Results were corrected with Bonferroni's test for multiple comparisons, and we performed power analysis for sample size calculations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using high\u2010resolution FLAIR images, we show evidence that fluid drainage emerges around the ICA petrous segment and joins lymphatic flow from cranial nerves in the upper neck, with this flow ultimately draining into the cervical lymph nodes bilaterally. Lymphatic signal at the petrous segment level was significantly thinner in females compared to males bilaterally (<jats:italic>w<\/jats:italic>\u00a0=\u00a0413, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0001 on the right, <jats:italic>w<\/jats:italic>\u00a0=\u00a0356, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001 on the left). Lymphatic drainage around the petrous segments of the ICAs bilaterally was thicker with age in males but not in females.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We describe the in vivo high\u2010resolution imaging characteristics of periarterial fluid drainage along the vessel walls of ICAs. This represents a potentially major channel for brain waste clearance. We also report interesting sex\u2010 and age\u2010based trends in these structures within our cohort.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jon.13056","type":"journal-article","created":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T06:10:10Z","timestamp":1664777410000},"page":"102-108","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["High\u2010resolution MRI to noninvasively characterize drainage around the carotid artery into the cervical lymph nodes"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6415-0874","authenticated-orcid":false,"given":"Zafer","family":"Keser","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garrett","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Radiology College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emin","family":"Cagil","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Ankara Numune Training and Research Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Tufan","sequence":"additional","affiliation":[{"name":"Geriatrician (PP) Silivrikapi Mh. Hisaralti Cd  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onder","family":"Albayram","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Medical University of South Carolina  Charleston South Carolina USA"},{"name":"Department of Neuroscience Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Sait","family":"Albayram","sequence":"additional","affiliation":[{"name":"Department of Radiology College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021204088"},{"key":"e_1_2_7_3_1","first-page":"e12053","article-title":"Clearance of interstitial fluid (ISF) and CSF (CLIC) group\u2010part of vascular 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