Objective To explore the characteristics in arterial lesions of CTA in diagnosis of persistent carotid-basilar artery anastomoses. Methods The CTA and MRI data of 6 patients with persistent carotid-basilar artery anastomoses were retrospectively analyzed. Results These 6 patients had 4 persistent trigeminal arteries ( PTA) , 1 persistent hypoglossal artery ( PHA) and 1 proatlantal intersegmental artery ( PIA) . Two cases of 4 PTA were right ipsilateral, and 2 cases were left ipsilateral. The veretral artery and basilar artery caudal to the anastomosis with the trigeminal artery were hypoplastic in 2 cases, and 1 case associated with left fetaltype posterior cerebral artery. One case of PHA originated from the right carotid artery, associated with an aneurysm of right middle cerebral artery and vertebral arteries completely artopied. One case of PIA originated from the right external carotid artery, associated with fetal right aortic arch, carotid artery occlusion, multiple aneurysms of right posterior communicating artery. Conclusions Persistent carotid-basilar artery anastomoses is a rare congenital vascular variant of the head and neck. PTA originates from the cavernous segment of the internal carotid artery, through the saddle back midline or bypass the saddle back, into the basilar artery. PHA originates from C1 segment of the internal carotid artery, courses through the enlarged hypoglossal canal and is anastomosed with the basilar artery. PIA originates from C1 segment of the internal carotid artery or external carotid artery, merge the vertebral artery, then through foramen magnum cranial.%目的 探讨CTA诊断永存颈内-基底动脉吻合的血管病变特点.方法 回顾性分析6例永存颈内-基底动脉吻合患者的CTA检查及MRI检查资料.结果 6例患者中,4例为永存三叉动脉(PTA),1例为永存舌下动脉(PHA),1例为永存寰前节间动脉(PIA).4例PTA中2例位于右侧,2例位于左侧,其中2例伴有近心端基底动脉和两侧椎动脉发育不良,1例伴有胚胎型左侧大脑后动脉.1例PHA起始于右侧颈内动脉颈段,合并右侧大脑中动脉动脉瘤,双侧椎动脉缺如.1例PIA起始于右侧颈外动脉,合并右位主动脉弓、双侧颈内动脉闭塞、右侧后交通动脉多发动脉瘤.结论 永存颈内-基底动脉吻合属于罕见的先天性头颈部血管变异.PTA起源于颈内动脉海绵窦段,穿过鞍背中线或绕过鞍背连于基底动脉.PHA起源于颈内动脉C1段,经扩大的舌下神经管入颅后与基底动脉吻合.PIA起源于颈内动脉C1段或颈外动脉,向上与椎动脉汇合后,经枕骨大孔入颅.
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