| Background:Cerebrovascular disease belongs to a common disease,the rate of disability and mortality are very high.It has become a huge threat to human health.The occurrence of cerebrovascular disease is closely related to the modality of the circle of Willis.The circle of Willis has a potential compensatory function.The morphological changes of the circle of Willis are susceptible to hemodynamics and have a certain relationship with the formation of intracranial aneurysms.Through the study of the anatomy,morphology and its classification of the circle of Willis and the discussion of the relationship between the development and the variation with the intracranial anterior and posterior communicating aneurysms,it can lay a foundation for the diagnosis and treatment of related diseases and the study of cerebral hemodynamics.Objective:(1)To observe and measure the interior diameter of the related arteries of the circle of Willis by 64-slice spiral CT angiography(2)To discuss its classification according to the integrity,development and variation.(3)To analyse the relationship between the development&variation of the circle of Willis and the anterior and posterior communicating aneurysms.Methods:170 cases of patients with CTA examinations in our hospital were analyzed retrospectively.114 patients with no obvious lesions were the control group,and 56 patients with anterior and posterior communicating aneurysms,were the study group:(1)The interior diameters of internal carotid artery(ICA).middle cerebral artery(MCA).anterior cerebral artery(ACA).posterior cerebral artery(PCA)?anterior communicating artery(AComA)?posterior communicating artery(PComA)were measured,then its proportional relationship was calculated.The statistical differences were analyzed between the left and right sides,gender and age.(2)The control group were classified into three types based on the integrity and development:the completed type,the comparatively completed type and the incompleted type.According to variation,each type was divided into variant and no variant.Then gived the supplement with its position and degree.(3)The definition of the development or variation of the circle of Willis and the classification in the previous article were used to analyze the development and variation of the circle of Willis in the study group and the control group,as well as the development and variation of anterior and posterior communicating aneurysms.Results:The branches and morphology of the circle of Willis can be showed clearly by the 64-slice spiral CT angiography:(1)The internal diameters of ICA,MCA,ACA,PCA,AComA and PComA were 2.77 ± 0.43 mm,2.05± 0.39 mm,1.50 ± 0.30 mm,1.40 ± 0.31 mm,1.12 ± 0.37 mm and 1.09 ± 0.31 mm.There were statistically differences(P<0.05)in the interior diameter of ACA,ICA between the left and right,and that of the PComA,ICA,MCA between the male and female.(2)In the 114 cases of the circle of Willis,there were 26 cases with completed type(12 cases with non-variation and 14 with variation),9 cases with comparatively completed type(0 case with non-variation and 9 with variation)and 79 cases with incompleted type(53 cases with non-variation and 26 with variation);The anterior circulation of hypogenesis was 11.3%and the posterior circulation was 64.8%.Both the anterior and posterior circulation of hypogenesis were 23.9%.One dysplasia accounted for 37.5%,with two accounting for 47.7%and the other three accounting for 14.8%.The anterior circulation of variation was 22.4%and the posterior circulation was 71.4%.Both the anterior and posterior circulation of variation were 6.1%.One variation accounted for 69.4%,with two accounting for 28.6%and the other three accounting for 2.0%.(3)Compared with the control group,the incompleteness of the circle of Willis in the study group was higher than that in the control group.The proportion of complete type and relatively complete type was lower in the study group than in the control group,there was statistically significant(P<0.05);Compared with the control group,the variation of the circle of Willis was not statistically significant(P>0.05);Comparison of dysplasia with the occurrence of anterior and posterior communicating aneurysm,there was not statistically significant(P>0.05);Comparison of variation with the occurrence of anterior and posterior communicating aneurysm,there was statistically significant(P<0.05);The variation of posterior communicating aneurysm was higher.Conclusion:The new classification of CW overcomes the unilateral consideration of the integrity or development of CW and adds the the comparatively completed type in order to generate associations between different types.In addition,dysplasia and variation were positioned and quantified.Combined the interior diameter measurements of CW,the anatomical basis will be provided for the diagnosis and treatment of CW disease and the hemodynamics study.At the same time,the formation of anterior and posterior communicating aneurysms is related to the development or variability of CW.CTA is beneficial to display CW development,variability and aneurysm. |
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