Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Department of Radiology, NYU Langone Health, New York, NY, USA.
Neuroradiology. 2021 Aug;63(8):1325-1333. doi: 10.1007/s00234-021-02657-3. Epub 2021 Feb 8.
To investigate the anatomical characteristics and clinical implications of the pterygovaginal artery (PtVA), a recurrent branch from the distal internal maxillary artery (IMA), which courses through the pterygovaginal canal that connects the pterygopalatine fossa and nasopharynx.
Eighty-two patients with 90 sides of cone-beam computed tomography (CBCT) reconstructed from rotational angiography of the external or common carotid artery with a field of view covering the pterygopalatine fossa were retrospectively reviewed. The origin from the IMA, branching type, distribution, and anastomoses was evaluated. The underlying lesions were 36 hypervascular lesions with possible supply from PtVA (17 cavernous sinus arteriovenous fistulas (AVFs), 6 anterior condylar AVFs, and 13 nasopharyngeal, parasellar, or paraclival tumors) and 46 other diseases.
PtVA was identified in 75 sides (83%). It originated from the pterygopalatine segment of the IMA in 45 sides (60%) and from the pterygoid segment in 30 sides (40%). It arose independently (77%), sharing the common trunk with the Vidian artery (15%) or with other branches. It ran posteromedially through the pterygovaginal canal to supply the mucosa over the nasopharyngeal roof, the choanae, and the pharyngeal ostium of the eustachian tube. It anastomosed with the ascending pharyngeal artery (n=37), the accessory meningeal artery (n=7), and the mandibular artery from the petrous internal carotid artery (n=2). It served as a feeder of osseous AVFs and skull base tumors.
PtVA was often identified by CBCT even in normal anatomy. Its detailed angio-anatomy could be evaluated in the presence of parasellar or paraclival hypervascular lesions.
研究翼内动脉（IMA）远端的翼阴道动脉（PtVA）的解剖学特征和临床意义，该动脉穿过连接翼腭窝和鼻咽的翼阴道管。
回顾性分析 82 例患者（90 侧）的锥形束 CT（CBCT），这些患者的旋转血管造影来自颈外或颈总动脉，视野覆盖翼腭窝。评估了从 IMA 发出的起源、分支类型、分布和吻合情况。潜在病变为 36 个可能由 PtVA 供应的高血供病变（17 个海绵窦动静脉瘘[AVF]、6 个前髁突 AVF 和 13 个鼻咽、鞍旁或斜坡旁肿瘤）和 46 个其他疾病。
在 75 侧（83%）中发现了 PtVA。它起源于 IMA 的翼腭段 45 侧（60%）和翼突段 30 侧（40%）。它独立起源（77%），与 Vidian 动脉（15%）或其他分支共享共同主干。它从后内侧穿过翼阴道管，供应鼻咽顶、后鼻孔和咽鼓管咽口的黏膜。它与咽升动脉（n=37）、脑膜副动脉（n=7）和发自岩骨内颈内动脉的下颌动脉（n=2）吻合。它是骨 AVF 和颅底肿瘤的供血动脉。
即使在正常解剖中，CBCT 也能经常识别出 PtVA。在存在鞍旁或斜坡旁高血供病变时，可以评估其详细的血管解剖结构。
