Neurofluid Dynamics and the Glymphatic System: A Neuroimaging Perspective

Korean J Radiol. 2020 Nov;21(11):1199-1209. doi: 10.3348/kjr.2020.0042. Epub 2020 Aug 11.


The glymphatic system hypothesis is a concept describing the clearance of waste products from the brain. The term "glymphatic system" combines the glial and lymphatic systems and is typically described as follows. The perivascular space functions as a conduit that drains cerebrospinal fluid (CSF) into the brain parenchyma. CSF guided to the perivascular space around the arteries enters the interstitium of brain tissue via aquaporin-4 water channels to clear waste proteins into the perivascular space around the veins before being drained from the brain. In this review, we introduce the glymphatic system hypothesis and its association with fluid dynamics, sleep, and disease. We also discuss imaging methods to evaluate the glymphatic system.

Keywords: Cerebrospinal fluid; Contrast media; Glymphatic system; Interstitial fluid; Magnetic resonance imaging, Diffusion imaging.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cerebrospinal Fluid / physiology
  • Contrast Media / chemistry
  • Diffusion Tensor Imaging
  • Glymphatic System / diagnostic imaging*
  • Glymphatic System / physiology
  • Humans
  • Hydrodynamics*
  • Magnetic Resonance Imaging
  • Nervous System Diseases / diagnostic imaging
  • Nervous System Diseases / physiopathology
  • Neuroimaging / methods*


  • Contrast Media