Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 102218 Beijing, China.
Department of Radiology, Sun Yat-sen Memorial hospital, Sun Yat-sen Universitye, 510123 Guangzhou, Guangdong, China.
J Integr Neurosci. 2022 Jan 20;21(1):2. doi: 10.31083/j.jin2101002.
The relationship between the severity of intracranial atherosclerotic disease and the circle of Willis integrity is unclear. In this brief report, we investigate the associations between symptomatic intracranial atherosclerotic disease and the integrity of the circle of Willis. Patients with symptomatic intracranial atherosclerosis were enrolled and underwent intracranial artery magnetic resonance vessel wall imaging and time-of-flight angiography. The presence or absence of an intracranial atherosclerotic plaque and its maximum wall thickness and stenosis were evaluated. The presence or absence of the A1 segment of the bilateral anterior cerebral arteries (from the internal carotid artery to the anterior communicating artery segment is called anterior cerebral artery A1 segment), and anterior communicating artery, the P1 segment of the bilateral posterior cerebral arteries (The P1 segment of the posterior cerebral artery is a horizontally outward segment), and bilateral posterior communicating arteries were determined. The associations of the intracranial plaque features with the integrity of the circle of Willis were analyzed. Of the 110 recruited subjects (57.2 ± 11.1 years; 65% males), 51 had intracranial plaques, and 44 had stenosis. In patients with bilateral A1 and P1 segments (n = 85), intracranial stenosis was more severe in patients with an anterior communicating artery than those without an anterior communicating artery (19.7% ± 21.7% vs. 1.4% ± 3.3%, = 0.046). In patients with bilateral A1 and P1 segments and an anterior communicating artery (n = 79), intracranial stenosis was more severe in patients with posterior communicating arteries than those without posterior communicating arteries (27.9% ± 23.7% vs. 13.5% ± 17.9%, = 0.007). The odds ratio of intracranial stenosis was 1.214 (95% confidence interval (CI), 1.054-1.398; = 0.007) in discriminating for the presence of posterior communicating arteries in patients with bilateral A1 and P1 segments and an anterior communicating artery after adjusting for confounding factors. The severity of intracranial atherosclerosis was independently associated with the presence of posterior communicating arteries in patients with a complete anterior part of the circle of Willis.
颅内动脉粥样硬化性疾病的严重程度与 Willis 环完整性之间的关系尚不清楚。在本简要报告中，我们研究了症状性颅内动脉粥样硬化性疾病与 Willis 环完整性之间的关系。入选了患有症状性颅内动脉粥样硬化的患者，并对其进行了颅内动脉磁共振血管壁成像和时间飞跃血管造影检查。评估了颅内粥样硬化斑块的存在与否及其最大管壁厚度和狭窄程度。确定了双侧大脑前动脉 A1 段（从颈内动脉到前交通动脉段的大脑前动脉 A1 段）、前交通动脉、双侧大脑后动脉 P1 段（大脑后动脉 P1 段为向外水平段）和双侧后交通动脉的存在与否。分析了颅内斑块特征与 Willis 环完整性的相关性。在 110 名入选的受试者中（57.2±11.1 岁；65%为男性），51 名患者存在颅内斑块，44 名患者存在狭窄。在双侧 A1 和 P1 段患者中（n=85），有前交通动脉的患者颅内狭窄程度比无前交通动脉的患者更严重（19.7%±21.7%比 1.4%±3.3%，=0.046）。在双侧 A1 和 P1 段且有前交通动脉的患者中（n=79），有后交通动脉的患者颅内狭窄程度比无前交通动脉的患者更严重（27.9%±23.7%比 13.5%±17.9%，=0.007）。在校正混杂因素后，双侧 A1 和 P1 段且有前交通动脉的患者中存在后交通动脉的颅内狭窄的优势比为 1.214（95%置信区间（CI）为 1.054-1.398；=0.007）。在 Willis 环前半部分完整的患者中，颅内动脉粥样硬化的严重程度与后交通动脉的存在独立相关。
