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与颅内动脉瘤相关的血管变异

Vascular Variations Associated with Intracranial Aneurysms.

作者信息

Orakdogen Metin, Emon Selin Tural, Somay Hakan, Engin Taner, Is Merih, Hakan Tayfun

机构信息

Haydarpasa Numune Teaching and Research Hospital, Neurosurgery Clinic, Istanbul, Turkey.

出版信息

Turk Neurosurg. 2017;27(6):853-862. doi: 10.5137/1019-5149.JTN.17839-16.1.

Abstract

AIM

To investigate the vascular variations in patients with intracranial aneurysm in circle of Willis.

MATERIAL AND METHODS

We used the data on 128 consecutive intracranial aneurysm cases. Cerebral angiography images were analyzed retrospectively. Arteries were grouped as anterior cerebral arterial system (ACS), posterior cerebral arterial system (PCS) and middle cerebral arterial system (MCS) for grouping vascular variations. Lateralization, being single/multiple, gender; and also any connection with accompanying aneurysms" number, localization, dimension, whether bleeding/incidental aneurysm has been inspected.

RESULTS

Variations were demonstrated in 57.8% of the cases. The most common variation was A1 variation (34.4%). The rate of variations was 36.7%, 24.2% and 10.2% respectively in ACS, PCS and MCS. MCS variations were significantly higher in males. Anterior communicating artery (ACoA) aneurysm observance rates were significantly higher and posterior communicating artery (PCoA) aneurysm and middle cerebral artery (MCA) aneurysm observance rates were significantly lower when compared to "no ACS variation detected" cases. In "PCS variation detected" cases, PCoA aneurysm observance rates and coexistence of multiple variations were significantly higher.

CONCLUSION

The rate of vascular variations in patients with aneurysms was 57.8%. Arterial hypoplasia and aplasia were the most common variations. ACS was the most common region that variations were located in; they were mostly detected on the right side. Coexistence of ACoA aneurysm was higher than PCoA and MCA aneurysms. In the PCS variations group, PCoA aneurysms were the most common aneurysms that accompanying the variation and multiple variations were more common than in the other two groups. The variations in MCS were most common in males.

摘要

目的

研究 Willis 环颅内动脉瘤患者的血管变异情况。

材料与方法

我们使用了 128 例连续颅内动脉瘤病例的数据。对脑血管造影图像进行回顾性分析。将动脉分为大脑前动脉系统(ACS)、大脑后动脉系统(PCS)和大脑中动脉系统(MCS)以对血管变异进行分组。分析了侧别、单发/多发、性别;以及与伴随动脉瘤的任何关联,包括动脉瘤数量、位置、大小,是否检查过出血性/偶然发现的动脉瘤。

结果

57.8%的病例存在变异。最常见的变异是 A1 变异(34.4%)。ACS、PCS 和 MCS 的变异率分别为 36.7%、24.2%和 10.2%。MCS 变异在男性中显著更高。与“未检测到 ACS 变异”的病例相比,前交通动脉(ACoA)动脉瘤的检出率显著更高,而后交通动脉(PCoA)动脉瘤和大脑中动脉(MCA)动脉瘤的检出率显著更低。在“检测到 PCS 变异”的病例中,PCoA 动脉瘤的检出率和多种变异共存的情况显著更高。

结论

动脉瘤患者的血管变异率为 57.8%。动脉发育不全和发育不良是最常见的变异。ACS 是变异最常见的区域;大多在右侧检测到。ACoA 动脉瘤共存的情况高于 PCoA 和 MCA 动脉瘤。在 PCS 变异组中,PCoA 动脉瘤是伴随变异最常见的动脉瘤,且多种变异比其他两组更常见。MCS 变异在男性中最常见。

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