脑底动脉环应用解剖与DSA对照分析

目的：通过脑底动脉环前半部解剖变异与脑血管DSA对照分析，探讨大脑前动脉(ACA)与前交通动脉(AcoA)及其与动脉瘤发生的关系。资料与方法：脑血管标本35具，观察脑底动脉环解剖结构及其变异。全脑血管DSA 50例。脑底动脉瘤57例，其中前交通动脉瘤13例，后交通动脉瘤24例，其他部位动脉瘤20例。结果：35具脑血管标本2具右侧A1发育不全，3具A1血管为多支及走行方向变异。全脑血管DSA50例，A1发育异常20例，其中一侧A1缺如9例，纤细11例。脑底动脉瘤57例，大脑前动脉A1纤细、缺如18例，其中前交通动脉瘤13例，颈内动脉前三分叉变异7例，动脉瘤发生部位与前交通动脉血流方向一致。结论：脑底动脉环前部的变异极为复杂，右侧变异多于左侧，与动脉瘤发生的关系密切。

Practical Anatomy of Willis'' Circle:A Comparison with DSA Manifestations

Objective To discuss the relationship between the anterior cerebral artery, anterior communicating artery and the occurrence of aneurysm by comparing anatomic variations of the anterior part of Willis' circle with DSA findings. Materials and Methods Thirty-five specimens of adult cerebral vessels were collected, and the anatomic variations of Willis' circle were observed. Whole cerebral DSA was performed in 50 cases and the observation was focused on the Willis' circle and its variations. A series of 57 aneurysms at cerebral base was collected, of which the aneurysms were located at anterior and posterior communicated artery in 13 and 24, respectively.Results Of 35 specimens of adult cerebral vessels, dysplasia of right A 1 was seen in 2, multiple branches and abnormal course of A 1 in 3. Of 50 cerebral DSA, developing abnormality of A 1 was found in 20, absent of A 1 at one side in 9 and thinned A 1 in 11. Of 57 cases with aneurysms at cerebral base, thinned or absent A 1 was found in 18, of which aneurysm of anterior communicated artery existed in 13 and variation of the three branches of internal carotid artery in 7.Conclusion The variation of the anterior part of Willis' circle is extremely complex, it occurs more often on the right side than the left side and is closely related to the occurrence of aneurysm.