| Objective: To investigate the3D TOF MRA findings of the persistenttrigeminal artery (PTA) and to discuss its image classification, genderdifference, age distribution feature, the development of basilar artery and theclinical value. To investigate and analyze the epidemiology of the PTA. Toestimate the diagnostic value and clinical significance of MRA.Methods: We found46cases of PTA in a total of27,185persons whohad been examined by MRA in our hospital in recent five years, part of themexamined by MRI scan. Retrospective analysis the images and clinical data ofthe46cases. Retrospectively analyzed the image and clinical materials of the46cases. Two senior doctors observed the images blindly. We reviewed thediagnosis firstly, then carried out epidemiological study (including incidence,age distribution, gender, frequency of embryonal posterior cerebral artery,vascular location of PTA, classification) and analyzed the differences andoccasions. All of the patients were classified, summarized, and analyzedaccording to Saltzman classification. Analyzing whether there was differencebetween Saltzman type I and typeⅡ in basilar artery dysplasia and discussingthe occasions. Describing whether there was significance between PTA caliberand basilar artery dysplasia and analyzing the occasions. Understanding theconditions of posterior communicating artery opening in PTA patients, anddiscussing the correlation between PTA and posterior communicating arteryopening.To assess the preponderances of different imageologic examinationsfor PTA. Part of the data of the results were analyzed by using SPSS13.0, thesignificance level is0.05.Results:1The cardinal symptoms of the46patients were dizzy, headache,limitation of activity, or paresthesia. No brain vascular malformations. Noinfarction lesions which completely consistented with the blood-supplying areas of PTA.2Within the27,185patients, there were16,231patients of male and10,954of female. Within the forty-six PTA cases, there were18cases (39%)of male and28cases (61%) of female. The incidence of PTA was0.17%,0.11%in male and0.26%in female. There was significant difference betweenthe incidences of different gender after statistically analyzing (chi-square testfor fourfold table). The incidence of PTA in female was higher than that ofmale.3The46patients of PTA aged from20years old to84years old(themean age was56.35±13.36), concentrating upon40to80. Most of them weregerontal patient. There were25(54.35%) PTA distributed on the left side and21(45.65%) on the right side. There was no persistent trigeminal arterydistributed on both sides. The difference between the left and the right was notsignificant.4Within the46cases of PTA,there were4(8.7%)of medial type and42(91.30%) of lateral type which was obviously more than the former.According to Saltzman classification, there were25cases (54.35%) ofSaltzman Type I which was commonly seen. There were18cases (39.13%) ofSaltzman Type II. There were3cases (6.52%) of Saltzman Type III which allstop to superior cerebellar artery.5After analyzing the images of the18cases of Saltzma Type II, weclassified the Saltzman type II into three subtypes according to connectionmode and trend of PTA. The three subtypes were thining and supplement forSaltzman classification. Salas classification in common with Saltzmanclassification analyzed the PTA, could provide abundant and detailedimageologic data for clinical.6There were26cases of PTA combined with basilar artery hypoplasia,including13cases of Saltzman type I,13cases of Saltzman typeⅡ.Therewere20cases of basilar artery which developed normally, including12casesof Saltzman typeⅠ,5cases of Saltzman typeⅡ,3cases of Saltzman type Ⅲ.Analyzing whether there was difference between Saltzman Type I and TypeⅡ in basilar artery development by using fourfold table chi-square test. We gotthe p (p=0.18>0.05) value, and considered there was no significant differencebetween the two of them in basilar artery dysplasia.7Within the46cases of PTA,there were16cases whose calibers werethicker which all combined with basilar artery dysplasia. There were30caseswhose calibers were thinner, including20cases of normal developed basilarartery,10cases of basilar artery dysplasia. After fourfold table chi-squaretesting, we got p=0.000<0.05. There was significant difference betweendifferent calibers in basilar artery development conditions. The calibers of allthe3cases of Saltzman Type Ⅲ of PTA is thinner.8There were21cases of the46cases of PTA existing embryonalposterior cerebral artery.The opening rate of embryonal posterior cerebralartery in PTA was higher than that in health adult.Conclusion:1MRA possess higher research value for PTA, it could be a method forlarge sample survey and investigate of PTA．2To get epidemiological data that close to real of PTA, we needadditional investigation, owing to the incomplete concordance of contrastingreports about examination, sample size, facilities level and so on of thesurveys.3The correct imageologic classification of PTA has very importantvalue for clinical diagnosis and study. Salas classification and Saltzmanclassification can provide adequate imageologic data for clinical, while themethod of which need to further test and explore that will validate the actualeffect.4From this study,we conclude that the Saltzman type II can beclassified into three subtypes according to PTA connection mode, which canprovide more affluent imageologic information for clinical.5The basilar artery dysplasia was associated with the caliber of PTA,while not associated with connection mode, probably correlated tocompensatory thickening of PTA causing by basilar artery dysplasia. PTA combined with higher occurrence of embryonal posterior cerebral artery,which may be correlated to geneogenous vessel variation of PTA.6PTA is rare,but its clinical significance and research value cannot benegligibled. It needs more attention, because the occurrence occasion, genderdifference, the occasion of combing with higher occurrence basilar arterydysplasia and other vascular malformation are still unknown. |
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