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

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

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。

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.