64层螺旋CTA显示胚胎型大脑后动脉伴发Willis环多血管段变异的价值

目的探讨64层螺旋CT血管成像(CTA)显示胚胎型大脑后动脉(FTP)伴发Willis环多血管段变异的价值。方法对比分析201例64层螺旋CTA诊断为FTP及201例诊断为非FTP(对照组)的影像学资料,观察Willis环的形态学改变。结果FTP组与对照组相比,FTP患者更易伴发大脑前动脉A1段、大脑后动脉P1段和椎动脉(VA)变异,且单侧FTP更易发生同侧A1段和P1段变细、发育不良或缺如(P<0.001),右侧VA较左侧更易发生变异(P<0.01)。而两组间PCoA、ACoA及基底动脉的变异差异无显著性意义(P>0.05)。结论FTP患者常伴发Willis环多血管段变异,64层螺旋CTA能够全面地评价脑血管的解剖与变异,有助于指导脑血管病的诊断与治疗。

Fetal origin of the posterior cerebral artery: variation of multi-segments of the circle of Willis demonstrated with 64-slice spiral CT angiography

Objective To investigate the value of 64-slice spiral CT angiography (CTA) in demonstrating variations of multi-segments of the Circle of Willis (CoW) in patients accompanying fetal origin of the posterior cerebral artery (FTP). Methods The imaging of 201 FTP patients diagnosed by 64-slice CTA and 201 non- FTP patients selected as the control group were comparatively analyzed. We observed the anomalies of the CoW morphology on 64-slice CTA. Results Compared with the control group, patients with an FTP are more prone to develop variations of the A1 segment of the anterior cerebral artery (P<0.01), P1 segment of the posterior cerebral artery (P<0.001) and vertebral arteries (VA) (P<0.001). Furthermore, small, hypoplasia or absence of ipsilateral A1 segment and P1 segment occurred more frequently in the unilateral FTP patients as compared to the controls (P<0.001). And the right VA is more prone to develop variations than the left (P<0.01). The variation of posterior communicating arteries (PCoA), anterior communicating artery (ACoA ) and basilar artery (BA) did not differ significantly between the two groups (P>0.05). Conclusion Patients with an FTP are frequently affecting more than one segment of CoW. 64-slice spiral CTA can evaluate the anatomy and variation of cerebral vessels roundly which conduce to conduct the diagnosis and therapy of cerebral vascular diseases.