Greggio Julien, Malamateniou Christina, Baruteau Kelly Pegoretti, Reyes-Aldasoro Constantino Carlos, Huckstep Odaro J, Francis Jane M, Williamson Wilby, Leeson Paul, Lewandowski Adam J, Lapidaire Winok
Department of Midwifery & Radiography, City St George's, School of Health & Psychological Sciences, University of London, Clerkenwell Campus, London, EC1V 0HB, UK.
Department of Neuroimaging, Kings' College London, London, SE5 8AF, UK.
BMC Med Imaging. 2025 Jan 30;25(1):33. doi: 10.1186/s12880-025-01562-y.
Preterm birth (< 37 weeks' gestation) alters cerebrovascular development due to the premature transition from a foetal to postnatal circulatory system, with potential implications for future cerebrovascular health. This study aims to explore potential differences in the Circle of Willis (CoW), a key arterial ring that perfuses the brain, of healthy adults born preterm.
A total of 255 participants (108 preterm, 147 full-term) were included in the analysis. High-resolution three-dimensional Time-of-Flight Magnetic Resonance Angiography (3D TOF MRA) datasets were analysed, measuring vessel diameters and classifying segments into different groups of CoW anatomical variations. Statistical comparisons assessed the prevalence of each variant group between preterm and full-term populations, as well as the relationship between CoW variability, sex, and degree of prematurity.
We identified 164 participants with variant CoW configurations. Unilateral segment hypoplasia (30%) and unilateral segment absence (29%) were the most common variations, with over 50% related to the posterior communicating artery (PComA). However, the incidence of absent segments was lower in preterm adults, who were more likely to exhibit variants associated with complete CoW configurations compared to full-term adults (p = 0.025). Preterm males had a higher probability of a group 1 variant (circles with one or more hypoplastic segments only) than the full-term group (p = 0.024). In contrast, preterm females showed higher odds of a group 4a variant (circles with one or more accessory segments, without any absent segments) in comparison to their full-term counterparts (p = 0.020).
Preterm birth is linked to a distinct vascular phenotype of CoW in adults born preterm, with a higher likelihood of a CoW configuration with hypoplastic segments but a lower likelihood of absent segments. Future work should focus on larger prospective studies and explore the implications of these findings for normal development and cerebrovascular disease. Furthermore, TOF MRA might be a useful adjunct in the neurovascular assessment of preterm-born individuals.
早产（妊娠<37周）会因从胎儿循环系统过早过渡到产后循环系统而改变脑血管发育，这可能对未来的脑血管健康产生影响。本研究旨在探讨早产出生的健康成年人的脑底动脉环（CoW）（灌注大脑的关键动脉环）的潜在差异。
共有255名参与者（108名早产，147名足月产）纳入分析。对高分辨率三维时间飞跃磁共振血管造影（3D TOF MRA）数据集进行分析，测量血管直径并将节段分类为CoW解剖变异的不同组。统计比较评估了早产和足月人群中各变异组的患病率，以及CoW变异性、性别和早产程度之间的关系。
我们确定了164名具有变异CoW构型的参与者。单侧节段发育不全（30%）和单侧节段缺失（29%）是最常见的变异，超过50%与后交通动脉（PComA）有关。然而，早产成年人中节段缺失的发生率较低，与足月成年人相比，他们更有可能表现出与完整CoW构型相关的变异（p = 0.025）。早产男性出现1组变异（仅带有一个或多个发育不全节段的脑底动脉环）的概率高于足月组（p = 0.024）。相比之下，早产女性出现4a组变异（带有一个或多个附属节段且无任何节段缺失的脑底动脉环） 的几率高于足月女性（p = 0.020）。
早产与早产出生的成年人中CoW的独特血管表型有关，具有发育不全节段的CoW构型的可能性更高，但节段缺失的可能性更低。未来的工作应侧重于更大规模的前瞻性研究，并探索这些发现对正常发育和脑血管疾病的影响。此外，TOF MRA可能是早产个体神经血管评估中的一种有用辅助手段。
