Human and nonhuman primate meninges harbor lymphatic vessels that can be visualized noninvasively by MRI.
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Here, we report the existence of meningeal lymphatic vessels in human and nonhuman primates (common marmoset monkeys) and the feasibility of noninvasively imaging and mapping them in vivo with high-resolution, clinical MRI. On T2-FLAIR and T1-weighted black-blood imaging, lymphatic vessels enhance with gadobutrol, a gadolinium-based contrast agent with high propensity to extravasate across a permeable capillary endothelial barrier, but not with gadofosveset, a blood-pool contrast agent. The topography of these vessels, running alongside dural venous sinuses, recapitulates the meningeal lymphatic system of rodents. In primates, meningeal lymphatics display a typical panel of lymphatic endothelial markers by immunohistochemistry. This discovery holds promise for better understanding the normal physiology of lymphatic drainage from the central nervous system and potential aberrations in neurological diseases.
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Recent magnetic resonance imaging studies in the living human brain and marmosets utilized a combination of gadolinium-based contrast agent (Gadovist) and blood-pool contrast agent (Vasovist) to demonstrate existence of the meningeal lymphatic system.
“Recent magnetic resonance imaging (MRI) studies in the living human brain and marmosets utilized a combination of gadolinium-based contrast agent (Gadovist) and blood-pool contrast agent (Vasovist) to demonstrate existence of the meningeal lymphatic system (4).”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [4]
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Experimental — accuracy not yet measuredThe dural lymphatics are a critical transport system of macromolecules, interstitial fluid, and CSF from the CNS into the cervical lymph nodes.
“The dural lymphatics are now recognized as a critical transport system of macromolecules, interstitial fluid, and CSF from the CNS into the cervical lymph nodes (Aspelund et al., 2015; Absinta et al., 2017; Louveau et al., 2018; Ahn et al., 2019).”
From Living on the Edge of the CNS: Meninges Cell Diversity in Health and Disease (2021) · cites this paper as Absinta et al., 2017
The extent of enhancing tissue within parasagittal dura does not resemble previously reported appearance of true dural lymphatic vessels (tubular-shaped, sub-millimeter, near venous sinus wall) nor classical MRI appearance of arachnoid granulations bulging into venous sinuses.
“The extent of enhancing tissue within parasagittal dura does not resemble the previously reported appearance of true dural lymphatic vessels, which are tubular-shaped structures of sub-millimeter cross-sectional diameter near the venous sinus wall3,4,11, and also far from the classical MRI appearance of arachnoid granulations bulging into venous sinuses12.”
From Cerebrospinal fluid tracer efflux to parasagittal dura in humans (2020) · cites this paper as [11]
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- Authors
- Absinta, M., Ha, S.-K., Nair, G., Sati, P., Luciano, N. J., Palisoc, M., Louveau, A., Zaghloul, K. A., Pittaluga, S., Kipnis, J., & Reich, D. S.
- Affiliations
- National Institutes of Health (US)
- University of Virginia (US)
- Corresponding author
- Reich, Daniel S
- ORCID
- Venue
- eLife
- Publisher
- eLife Sciences Publications, Ltd
- Published
- 2017-10-03
- Volume
- 6
- ISSN
- 2050-084X (ISSN-L)
- PMC
- PMC5626482
- OpenAlex
- W2760815599
- Cited by
- 643
- References
- 32
- Citations by year
- 2026: 61 · 2025: 88 · 2024: 73 · 2023: 77 · 2022: 79 · 2021: 78 · 2020: 70 · 2019: 60 · 2018: 51 · 2017: 4 · 2012: 1
- FWCI
- 22.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- eLife (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Neurological Disorders and Stroke (Intramural Research Program)
- National Multiple Sclerosis Society (Postdoctoral Fellowship)
- Conrad N. Hilton Foundation (Marilyn Hilton Award for Innovation in Multiple Sclerosis Research)
- National Cancer Institute (Intramural Research Program)
- National Institute on Aging (R01AG034113)
- Lymphatic Education and Research Network (Postdoctoral fellowship)
- Topics
- Health Sciences › Medicine › Oncology › Lymphatic System and Diseases
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
- Health Sciences › Medicine › Surgery › Lymphatic Disorders and Treatments
- Keywords
- meningeal lymphatic vessels, meningeal lymphatic system, non-human primates, Callithrix jacchus, human brain, gadobutrol, gadofosveset, contrast extravasation, lymphatic endothelial markers, dural venous sinuses, black-blood imaging
- MeSH terms
- Animals, Callithrix, Humans, Magnetic Resonance Imaging, Meninges, Lymphatic Vessels
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