MSCT分析Willis环完整性与环上动脉瘤的关系

摘要

目的 通过MSCT脑血管成像探讨Willis环完整性与环上动脉瘤的关系.方法 回顾性分析580例拟诊颅内血管性病变患者的CTA检查资料,基于轴位薄层图像、VR、MIP及MPR图像,观察Willis环形态结构及环上动脉瘤发生情况.根据Willis环完整性分为Ⅰ型(Willis环完整)、Ⅱ型(前循环完整但后循环不完整)、Ⅲ型(前循环不完整但后循环完整)及Ⅳ型(前、后循环均不完整).并进行统计学分析.结果 580例中,Willis环分型为Ⅰ型118例(118/580,20.34％)、Ⅱ型344例(344/580,59.31％)、Ⅲ型25例(25/580,4.31％)、Ⅳ型93例(93/580,16.03％).Ⅰ～Ⅳ型患者中Willis环上动脉瘤发生率分别为16.10％(19/118)、14.83％ (51/344)、32.00％(8/25)、23.66％ (22/93).不同类型Willis环患者动脉瘤发生率差异有统计学意义(f=8.013,P=0.046).不同性别间Willis环分型差异有统计学意义(x2=12.631,P=0.006),且女性Willis环上动脉瘤发生率高于男性25.00％ (63/252) vs 11.28％ (37/328);x2=18.80,P＜0.025].结论 多数Willis环结构并不完整,不完整的Willis环更易发生动脉瘤,且女性动脉瘤发生率高于男性.%Objective To observe the relationship between the integrity of Willis circle and aneurysm with MSCT angiography.Methods CTA data of 580 patients with intracranial vascular lesions were retrospectively analyzed.The morphological structure of Willis circle and the occurrence of aneurysm were observed based on axial thin-layer,VR,MIP and MPR images.According to the integrity,Willis circle were divided into type Ⅰ (Willis circle complete),type Ⅱ (the anterior circulation complete but the posterior circulation incomplete),type Ⅲ (the anterior circulation incomplete but the posterior circulation complete) and type Ⅳ (both the anterior and posterior circulation incomplete) for statistical analysis.Results For the classification of Willis circle,there were 118 cases of type Ⅰ (118/580,20.34％),344 of type Ⅱ (344/580,59.31％),25 of type Ⅲ (25/580,4.31％) and 93 cases of type Ⅳ (93/580,16.03％).The incidence of Ⅰ-Ⅳtypes of Willis circle with aneurysm accounted for 16.10％ (19/118),14.83％ (51/344),32.00％ (8/25) and 23.66％ (22/93),respectively.The incidences of aneurysm in patients with different types of Willis circlewere statistically significant (x2=8.013,P=0.046).There was statistical difference of the type of Willis circle between different genders (x2=12.631,P=0.006),and the incidence of aneurysm in females was higher than that in males (25.00％ [63/252] vs 11.28％ [37/328];x2 =18.80,P＜0.025).Conclusion Most Willis circle were not complete,and incomplete Willis circle aneurysm tended to occur in females with higher aneurysm rate.