MDCT血管成像研究黔南少数民族地区颅底Willis环解剖变异及分型

MDCT angiographic study anatomic variation and classification of Willis ring of skull base in minority areas of Qiannan

目的探讨贵州省黔南布州依族及苗族成人Willis环解剖变异及分型,为黔南地区少数民族脑血管疾病提供对照。方法本研究为回顾性研究,连续纳入黔南州人民医院2011年12月~2017年2月期间CT及MRI检查正常,并作CTA检查黔南布依族或苗族成人513名,将检查数据采用西门子signo工作站,行VR、MIP及MPR多模式、多角度观察Willis环的发育情况进行分型,分析各种类型的情况。结果根据组成动脉的发育情况,将513例正常脑动脉Willis环分为4型,Ⅰ型3.7%(19例);Ⅱ型0.1%(5例);Ⅲ型65.5%(336例),根据后循环的发育情况分为5个亚型:Ⅲa,18.9%(97例);Ⅲb,32.2%(165例);Ⅲc,2.5%(13例);Ⅲd,4.5%(23例);Ⅲe,7.4%(38例);Ⅳ型29.8%(153例),根据前、后循环的发育情况组合将Ⅳ型分为5个亚型:Ⅳa,21%(108例);Ⅳb型,1.2%(6例);Ⅳc,1.6%(8例);Ⅳd型,1.9%(10例);Ⅳe型,4.1%(21例)。结论 CTA是一种无创、有效的评价脑底动脉环类型的方法,利用CTA评价黔南地区少数民族脑底动脉环可以为其他与脑血管类型有关疾病提供正常对照;黔南少数民族地区对称型Willis环显示率较低,以Ⅲ型为主,Ⅳ型次之。

Objective To explore the anatomical variation and classification of Willis ring in the southern Guizhou province, and to provide a control for the cerebrovascular diseases of ethnic minorities in Qiannan area. Methods In this study, retrospective study was carried out continuously in the Qiannan People＇s Hospital from December 2011 to February 2017. CT and MRI were normal and CTA was used to check the 513 of the Buyi or Miao adults in Qiannan. The data were examined by Siemens signo workstations,row VR, MIP and MPR,multi-modal and multi-angle observation of the Willis ring development were used for classification and type analysis. Results According to the development of arterial arteries, 513 cases of normal cerebral artery Willis ring were divided into four types, typeⅠ3.7% （19 cases）, typeⅡ0.1% （5 cases）,and type Ⅲ 65.5% （336 cases）, according to the development situation of the posterior circulation is divided into 5 subtypes： IIIa 18.9% （97 cases）, IIIb 32.2% （165 cases）, IIIc 2.5% （13 cases）, Ⅲd 4.5% （23 cases）, Ⅲe 7.4% （38 cases） and Type IV 29.8% （153 cases）; according to the development situation before and after the circulation of type IV combination will be divided into 5 subtypes： IVa 21% （108 cases）, IVb 1.2% （6 cases）,IVc, 1.6% （8 cases）, IVd, 1.9% （10 cases）, and IVe, 4.1% （21 cases）. Conclusion CTA is a noninvasive and effective method for evaluation of the basilar artery type. It is possible to evaluate the basilar artery ring in the Qiannan area by CTA. It can provide normal control for other diseases related to cerebrovascular type. The symmetrical type Willis ring display rate is low, whereas type Ⅲ is the main type followed by type Ⅳ.