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Giant perivascular space in the anterior superior temporal gyrus: Imaging characteristics to avoid misdiagnosis

Giant perivascular spaces (PVS) may mimic cortically-based neoplasm such as dysembryoplastic neuroepithelial tumor. The recently recognized location in the anterior superior temporal gyrus adjacent to the middle cerebral artery is an important diagnostic clue.[1,2] Giant PVS follow cerebrospinal fluid signal on all MRI sequences and do not demonstrate contrast enhancement; however, variable perilesional edema is observed, which may relate to adjacent gliosis or several adjacent tiny PVS[1,2] Temporal stability is necessary to confirm its benign nature and avoid unnecessary intervention.