摘要
Abstract
Objective To investigate the compensatory and perfusion differences in acute ischemic cerebrovascular disease (ICVD) with collateral establishment of circle of Willis by computed tomography angiography (CTA) and computed tomography perfusion (CTP). Methods This retrospective study enrolled 231 patients with acute ICVD, who were treated in Beijing Friendship Hospital of Capital Medical University from December 2011 to February 2013. They were divided into cerebral infarction (CI) group and transient ischemic attack (TIA) group according to diffusion weighted imaging of magnetic resonance imaging. Based on their symptoms and imaging, the patients were divided into anterior circulation TIA (59 cases), posterior circulation TIA (66 cases), anterior CI (57 cases) and posterior CI (49 cases). Collect the data of CTA and CTP to describe the circle of Willis, and divide them into four types: (1) Type I, showing an intact circle;(2) Type II, anterior part incompletely; (3) Type III, posterior part incompletely; (4) Type IV, both anterior and posterior parts incompletely. And analyze the relation between the circle of Willis and cerebral ischemic disease in those 4 groups. Results In all 231 cases, circle of Willis Type I, II, III and IV was found in 7.8%, 4.3%, 38.5%and 49.4%, respectively. The frequency of Type I and III in TIA group were more than these in CIgroup. The frequency of the anterior communicating artery (ACoA) segment in TIA group were more than CI group (χ2=10.832,P=0.001). The patients with abnormal perfusion area had most rate of Willis circle Type IV (60.33%), the rates of Type I, II, III were less than normal perfusion group (χ2=12.356,P=0.006). Conclusion Our study suggests that the potential of the primary collateral circulation is ultimately determined by the anatomic variability of Willis circle. ACoA may play a compensatory role when ICVD occurred. Perfusion abnormality in patients with ICVD was associated with the incomplete collateral circulation of Willis circle.关键词
急性缺血性脑血管病/Wilis环/侧支循环Key words
Acute ischemic cerebrovascular disease/Circle of Willis/Cerebral collateral circulation
