基于磁共振血管造影图像的永存三叉动脉及其分类研究。
A Study on the Persistent Trigeminal Artery and Its Classification Based on Magnetic Resonance Angiograph Images.
机构信息
From the Medical Imaging Department, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
出版信息
J Comput Assist Tomogr. 2022;46(4):645-650. doi: 10.1097/RCT.0000000000001309. Epub 2022 Jun 4.
BACKGROUND
The persistent trigeminal artery (PTA) is the most common remnant of primitive circulation, communicating the developing carotid and vertebrobasilar junction.
PURPOSE
This study aimed to evaluate the implementation of magnetic resonance angiography for the detection of PTA and to reclassify the variations based on Weon typing. Moreover, the correlation of various Weon types with the posterior cerebral artery (PCA), Willis ring, basilar artery (BA) dysplasia, and the relationship between PTA and arteriosclerosis were analyzed.
METHODS
From November 2017 to October 2019, a total of 48,184 patients underwent magnetic resonance angiography examination in our hospital, and 79 patients were diagnosed with PTA. Of these, 70 patients with complete radiological and clinical information were included in this study.
RESULTS
Among the 70 patients with complete data, 27 were classified as Weon type I (38.6%), 7 as type II (10%), 14 as type III (20%), 8 as type IV (11.4%), and 3 as type V (4.3%: type Va, 1 case; type Vb, 2 cases). The remaining 11 cases were PCA with mixed blood supply, so the new type VI was divided into 3 subtypes: type VIa, type VIb, and type VIc, and each subtype of type V was further refined into 4 subtypes. There were 32 cases of PTA with BA dysplasia, including 14 with type I (51.9%), 5 with type II (71.4%), 2 with type III (14.3%), 5 with type IV (62.5%), and 6 with type VI (54.5%). Cerebral infarction was found in 55 cases (78.6%) of PTA, among which 11 had a cerebral infarction in the posterior circulation blood supply area. There were 46 cases (65.7%) accompanied by intracranial arteriosclerosis, and in 6 cases, arteriosclerosis mainly occurred in the posterior circulation.
CONCLUSIONS
We redefined the classification of PTA based on Weon typing for a better understanding of clinical symptoms and surgical risks. Moreover, PTA was correlated with the fetal origin of PCA, BA dysplasia, and posterior circulation arteriosclerosis. These factors may increase the incidence of cerebral infarction in the posterior circulation blood supply area.
背景
永存三叉动脉（PTA）是最常见的原始循环残留动脉，沟通了发育中的颈动脉和椎基底动脉交界处。
目的
本研究旨在评估磁共振血管造影（MRA）在检测 PTA 中的应用，并根据 Weon 分型重新分类。此外，还分析了各种 Weon 型与大脑后动脉（PCA）、Willis 环、基底动脉（BA）发育不良以及 PTA 与动脉硬化之间的相关性。
方法
自 2017 年 11 月至 2019 年 10 月，我院共对 48184 例患者进行了 MRA 检查，其中 79 例诊断为 PTA。其中，70 例患者的影像学和临床资料完整，纳入本研究。
结果
在 70 例资料完整的患者中，27 例被分为 Weon Ⅰ型（38.6%），7 例为Ⅱ型（10%），14 例为Ⅲ型（20%），8 例为Ⅳ型（11.4%），3 例为Ⅴ型（4.3%：Ⅴa 型 1 例，Ⅴb 型 2 例）。其余 11 例为 PCA 伴混合血供，因此将新的Ⅵ型分为 3 个亚型：Ⅵa、Ⅵb 和Ⅵc，每个Ⅴ型亚型进一步细化为 4 个亚型。32 例 PTA 伴 BA 发育不良，其中 14 例为Ⅰ型（51.9%），5 例为Ⅱ型（71.4%），2 例为Ⅲ型（14.3%），5 例为Ⅳ型（62.5%），6 例为Ⅵ型（54.5%）。55 例（78.6%）PTA 患者发现脑梗死，其中 11 例为后循环供血区脑梗死。46 例（65.7%）伴有颅内动脉硬化，其中 6 例动脉硬化主要发生在后循环。
结论
我们根据 Weon 分型重新定义了 PTA 的分类，以便更好地了解临床症状和手术风险。此外，PTA 与 PCA 的胎生起源、BA 发育不良和后循环动脉硬化有关。这些因素可能会增加后循环供血区脑梗死的发生率。
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