Anatomical variations of the circle of Willis: evaluation with CT angiography

Objectives: The aim of this study was to investigate anatomic variants and anomalies of the circle of Willis using computed tomography angiography (CTA). Methods: CTA images of 770 patients obtained from Tepecik Training and Research Hospital between January 2012 to January 2017 were retrospectively reviewed to identify the anatomical vascular variations of the circle of Willis. Results: After exclusion, 751 patients (348 females, 403 males, mean age 54.6 years, range 18–90 years) were enrolled into the study. The anatomical variations related to the posterior communicating artery (PcoA) were the most common, whereas anatomical variations related to the middle cerebral artery (MCA) were the least common variations among arteries. Hypoplasia of the A1 segment was the most common (14.6%) variation of the anterior cerebral artery (ACA) and fenestration of this artery was the least common variation (1,06%) observed only in A1 segment. Bilateral absence of the PcoA was seen in 27.56% of the patients. Fenestration was more commonly detected in anterior communicating artery (AcoA) (10.12%), followed by MCA (1.06%), ACA (1,06%) and PCA (0.67%). Duplication was the least common variation which was detected in MCA, AcoA and PcoA. Conclusion: Arterial variations of the circle of Willis are not rare and can be non-invasively evaluated using CTA.

Kaynakça

Dimmick SJ, Faulder KC. Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics 2009;29:1027– 43.

van Rooij SB, van Rooij WJ, Sluzewski M, Sprengers ME. Fenestrations of intracranial arteries detected with 3D rotational angiography. AJNR Am J Neuroradiol 2009;30:1347–50.

Osborn AG. Diagnostic cerebral angiography (2nd ed). Philadelphia, PA: Lippincott Williams & Wilkins; 1999.

Komiyama M, Nakajima H, Nishikawa M, Yasui T. Middle cerebral artery variations: duplicated and accessory arteries. AJNR Am J Neuroradiol 1998;19:45–9.

Parmar H, Sitoh YY, Hui F. Normal variants of the intracranial circulation demonstrated by MR angiography at 3T. Eur J Radiol 2005; 56:220–8.

Jayaraman MV, Mayo-Smith WW, Tung GA, Haas RA, Rogg JM, Mehta NR, Doberstein CE. Detection of intracranial aneurysms: multi-detector row CT angiography compared with DSA. Radiology 2004;230:510–8.

Pekcevik Y, Pekcevik R. Variations of the cerebellar arteries at CT angiography. Surg Radiol Anat 2014;36:455–61.

Nussbaum ES, Defillo A, Janjua TM, Nussbaum LA. Fenestration of the middle cerebral artery with an associated ruptured aneurysm. J Clin Neurosci 2009;16:845–7.

Songur A, Gonul Y, Ozen OA, Kucuker H, Uzun I, Bas O, Toktas M. Variations in the intracranial vertebrobasilar system. Surg Radiol Anat 2008;30:257–64.

Kiroğu Y, Karabulut N, Oncel C, Akdogan I, Onur S. Bilateral symmetric junctional infarctions of the cerebellum: a case report. Surg Radiol Anat 2010;32:509–12.

de Gast AN, van Rooij WJ, Sluzewski M. Fenestrations of the anterior communicating artery: incidence on 3D angiography and relationship to aneurysms. AJNR Am J Neuroradiol 2008;29:296–8.

Reis CV, Zabramski JM, Safavi-Abbasi S, Hanel RA, Deshmukh P, Preul MC. The accessory middle cerebral artery: anatomic report. Neurosurgery 2010;66:E1217.

Hamidi C, Bükte Y, Hattapoğlu S, Ekici F, Tekbaş G, Önder H, Gümüş H, Bilici A. Display with 64-detector MDCT angiography of cerebral vascular variations. Surg Radiol Anat 2013;35:729–36.

Kashiwazaki D, Kuroda S, Horiuchi N, Takahashi A, Asano T, Ishikawa T, Iwasaki Y. Ruptured aneurysm of bihemispheric anterior cerebral artery bifurcation: case report. No Shinkei Geka 2005;33: 383–7.

Cinnamon J, Zito J, Chalif DJ, Gorey MT, Black KS, Scuderi DM. Aneurysm of the azygos pericallosal artery: diagnosis by MR imaging and MR angiography. AJNR Am J Neuroradiol 1992;13:280–2.

Bayrak AH, Senturk S, Akay HO, Ozmen CA, Bukte Y, Nazaroglu H. The frequency of intracranial arterial fenestrations: a study with 64-detector CT-angiography. Eur J Radiol 2011;77:392–6.

van der Lugt A, Buter TC, Govaere F, Siepman DA, Tanghe HL, Dippel DW. Accuracy of CT angiography in the assessment of a fetal origin of the posterior cerebral artery. Eur Radiol 2004;14: 1627–33.

van Overbeeke JJ, Hillen B, Tulleken CA. A comparative study of the circle of Willis in fetal and adult life: the configuration of the posterior bifurcation of the posterior communicating artery. J Anat 1991; 176:45–54.

van Raamt AF, Mali WP, van Laar PJ, van der Graaf Y. The fetal variant of the circle of Willis and its influence on the cerebral collateral circulation. Cerebrovasc Dis 2006;22:217–24.

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