Uchino Akira, Minote Misako
Department of Radiology, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan.
Department of Neurology, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan.
Surg Radiol Anat. 2025 Apr 24;47(1):128. doi: 10.1007/s00276-025-03642-8.
To describe a case of right posterior cerebral artery (PCA) fenestration coexisting with bilateral superior cerebellar artery (SCA) duplication.
A 65-year-old woman with meningitis underwent cranial magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) using a 3-Tesla scanner. MRA was performed using a standard 3-dimensional time-of-flight technique.
MRI showed sulcal hyperintensity in the bilateral occipito-parietal regions on a fluid-attenuated inversion recovery (FLAIR) sequence, suggesting meningitis. MRA revealed no pathological lesions; however, fenestration of the right PCA at the P1-P2 junction and duplications of the bilateral SCAs were incidentally observed.
Using MRA, we diagnosed the first case of right PCA fenestration coexisting with bilateral SCA duplication. Although its clinical significance is limited, there may be a risk of misinterpretation or diagnostic confusion with pathological conditions such as aneurysms or dissections. Therefore, accurate identification of these arterial variations during MRA interpretation is essential. Careful observation of MRA images, along with the creation of partial volume-rendering images, is useful and important for diagnosing rare arterial variations.
描述一例右侧大脑后动脉（PCA）开窗并存双侧小脑上动脉（SCA）重复的病例。
一名65岁患脑膜炎的女性使用3特斯拉扫描仪进行了头颅磁共振成像（MRI）和磁共振血管造影（MRA）检查。MRA采用标准的三维时间飞跃技术进行。
MRI的液体衰减反转恢复（FLAIR）序列显示双侧枕顶叶区域脑沟高信号，提示脑膜炎。MRA未发现病理性病变；然而，偶然观察到右侧PCA在P1-P2交界处开窗以及双侧SCA重复。
通过MRA，我们诊断出首例右侧PCA开窗并存双侧SCA重复的病例。尽管其临床意义有限，但可能存在与动脉瘤或夹层等病理状况发生误判或诊断混淆的风险。因此，在MRA解读过程中准确识别这些动脉变异至关重要。仔细观察MRA图像以及创建部分容积渲染图像，对于诊断罕见的动脉变异是有用且重要的。
