Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; PET Imaging Center, University Hospital of North Norway, Tromsø, Norway.
Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurosurgery, Ophthalmology, and Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway.
J Neurol Sci. 2023 Sep 15;452:120740. doi: 10.1016/j.jns.2023.120740. Epub 2023 Jul 25.
Studies on patients suggest an association between anatomical variations in the Circle of Willis (CoW) and intracranial aneurysms (IA), but it is unclear whether this association is present in the general population. In this cross-sectional population study, we investigated the associations between CoW anatomical variations and IA.
We included 1667 participants from a population sample with 3 T MRI time-of-flight angiography (40-84 years, 46.5% men). Saccular IAs were defined as protrusions in the intracranial arteries ≥2 mm, while variants of the CoW were classified according to whether segments were missing or hypoplastic (< 1 mm). We used logistic regression, adjusting for age and IA risk factors, to assess whether participants with incomplete CoW variants had a greater prevalence of IA and whether participants with specific incomplete variants had a greater prevalence of IA.
Participants with an incomplete CoW had an increased prevalence of IA (OR, 2.3 [95% CI 1.05-5.04]). This was mainly driven by the variant missing all three communicating arteries (OR, 4.2 [95% CI 1.7-1 0.3]) and the variant missing the P1 segment of the posterior cerebral artery (OR, 3.6 [95% CI 1.2-10.1]). The combined prevalence of the two variants was 15.4% but accounted for 28% of the IAs.
The findings suggest that an incomplete CoW is associated with an increased risk of IA for adults in the general population.
对患者的研究表明，Willis 环（CoW）的解剖变异与颅内动脉瘤（IA）之间存在关联，但尚不清楚这种关联是否存在于普通人群中。在这项横断面人群研究中，我们研究了 CoW 解剖变异与 IA 之间的关系。
我们纳入了来自人群样本的 1667 名参与者，这些参与者接受了 3T MRI 时飞血管造影（40-84 岁，46.5%为男性）。囊状 IA 定义为颅内动脉≥2mm 的突起，而 CoW 的变异则根据是否存在缺失或发育不全的节段（<1mm）进行分类。我们使用逻辑回归，调整年龄和 IA 危险因素，评估 CoW 不完全变异的参与者 IA 的患病率是否更高，以及具有特定不完全变异的参与者 IA 的患病率是否更高。
CoW 不完全的参与者 IA 的患病率增加（OR，2.3[95%CI 1.05-5.04]）。这主要是由所有三个交通动脉缺失的变异（OR，4.2[95%CI 1.7-10.3]）和大脑后动脉 P1 段缺失的变异（OR，3.6[95%CI 1.2-10.1]）驱动的。这两种变异的联合患病率为 15.4%，但占 IA 的 28%。
这些发现表明，在普通人群中，CoW 不完全与成人 IA 的风险增加有关。
