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利用 3D TOF 血管造影对大人群样本进行 Willis 环变异分析:特罗姆瑟研究。

Variations in the Circle of Willis in a large population sample using 3D TOF angiography: The Tromsø Study.

机构信息

Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.

PET Centre, University Hospital of North Norway, Tromsø, Norway.

出版信息

PLoS One. 2020 Nov 3;15(11):e0241373. doi: 10.1371/journal.pone.0241373. eCollection 2020.

Abstract

The main arteries that supply blood to the brain originate from the Circle of Willis (CoW). The CoW exhibits considerable anatomical variations which may have clinical importance, but the variability is insufficiently characterised in the general population. We assessed the anatomical variability of CoW variants in a community-dwelling sample (N = 1,864, 874 men, mean age = 65.4, range 40-87 years), and independent and conditional frequencies of the CoW's artery segments. CoW segments were classified as present or missing/hypoplastic (w/1mm diameter threshold) on 3T time-of-flight magnetic resonance angiography images. We also examined whether age and sex were associated with CoW variants. We identified 47 unique CoW variants, of which five variants constituted 68.5% of the sample. The complete variant was found in 11.9% of the subjects, and the most common variant (27.8%) was missing both posterior communicating arteries. Conditional frequencies showed patterns of interdependence across most missing segments in the CoW. CoW variants were associated with mean-split age (P = .0147), and there was a trend showing more missing segments with increasing age. We found no association with sex (P = .0526). Our population study demonstrated age as associated with CoW variants, suggesting reduced collateral capacity with older age.

摘要

大脑供血的主要动脉源自 Willis 环(CoW)。CoW 存在相当大的解剖学变异,这可能具有临床意义,但在普通人群中,这种变异性的特征描述不足。我们在一个社区居住的样本中评估了 CoW 变体的解剖变异性(N=1864 人,男性 874 人,平均年龄 65.4 岁,范围 40-87 岁),并评估了 CoW 动脉节段的独立和条件频率。CoW 节段在 3T 时间飞跃磁共振血管造影图像上被分类为存在或缺失/发育不良(w/1mm 直径阈值)。我们还检查了年龄和性别是否与 CoW 变体有关。我们确定了 47 种独特的 CoW 变体,其中 5 种变体构成了样本的 68.5%。完整的变体在 11.9%的受试者中发现,最常见的变体(27.8%)同时缺失了两条后交通动脉。条件频率显示了 CoW 中大多数缺失节段之间相互依存的模式。CoW 变体与平均分裂年龄相关(P=0.0147),并且随着年龄的增加,缺失的节段越多,呈趋势性。我们没有发现与性别有关(P=0.0526)。我们的人群研究表明,年龄与 CoW 变体有关,这表明随着年龄的增长,侧支循环能力降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e3c/7608873/84eb59384f15/pone.0241373.g001.jpg

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