Persistent proatlantal intersegmental artery: a consideration based on multi-slice spiral computed tomography angiography.

IF 1.4 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2024-12-02 DOI:10.1007/s00276-024-03524-5

Qin Xiao, Yi Mao, Shunan Wang, Xinju Yang

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引用次数: 0

Abstract

Background: Multi-slice spiral computed tomography (CT) angiography (MSCTA) has become the primary non-invasive image technique for evaluating cephalic and cervical vascular anatomy, especially vascular variant such as persistent carotid-basilar anastomosis. Persistent proatlantal intersegmental artery (PPIA) is an example of a rare persistent carotid-basilar anastomosis that deserves to be featured through this imaging technic.

Purpose: The aim of this study is to explore the imaging characteristics of the PPIA using MSCTA and to assess its clinical significance. Furthermore, the study seeks to propose a novel classification system predicated on the posterior circulation blood supply.

Materials and methods: This retrospective analysis evaluated the imaging and clinical data of 11 patients diagnosed with a PPIA using MSCTA.

Results: The incidence of the PPIA was found to be 0.01%. Classification based on the origin of the PPIA identified two cases (18.2%) as type I and nine cases (81.8%) as type II. This study introduced a novel classification system for PPIA, which is based on the posterior circulation blood supply, encompassing the persistent artery, vertebral artery, and posterior communicating artery. Among the 11 patients with PPIA, there were 11 instances of ipsilateral vertebral artery agenesis, three cases of contralateral vertebral artery hypoplasia, one case of contralateral vertebral artery agenesis, two cases of persistent artery hypoplasia, and two cases of basilar artery hypoplasia. Furthermore, the study identified two patients with aneurysms, one with cerebral infarction, and one with a Pulmonary Arteriovenous Fistula.

Conclusion: The proposed classification system for PPIA enhances the understanding of posterior circulation blood supply, which is vital for pre-interventional and pre-surgical imaging assessments. In PPIA cases, the ipsilateral vertebral artery is consistently hypoplastic, and the PPIA predominantly serves the posterior fossa's vascularization in about 75% of cases.

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基于多层螺旋计算机断层血管造影的持续性寰前节段间动脉研究。

背景：多层螺旋计算机断层（CT）血管造影（MSCTA）已成为评估头颈部血管解剖的主要非侵入性图像技术，特别是血管变异，如持续性颈-基底动脉吻合。持续性寰前节段间动脉（PPIA）是一种罕见的持续性颈动脉-基底动脉吻合的例子，值得通过这种成像技术进行描述。目的：本研究旨在探讨MSCTA对PPIA的影像学特征及临床意义。此外，该研究试图提出一种基于后循环血液供应的新分类系统。材料和方法：回顾性分析11例经MSCTA诊断为PPIA的患者的影像学和临床资料。结果：PPIA的发生率为0.01%。根据PPIA来源的分类，2例（18.2%）为I型，9例（81.8%）为II型。本研究提出了一种新的PPIA分类系统，该系统以后循环血液供应为基础，包括持久动脉、椎动脉和后交通动脉。11例PPIA患者中，同侧椎动脉发育不全11例，对侧椎动脉发育不全3例，对侧椎动脉发育不全1例，持续性动脉发育不全2例，基底动脉发育不全2例。此外，该研究确定了2例动脉瘤患者，1例脑梗死，1例肺动静脉瘘。结论：提出的PPIA分类系统提高了对后循环血供的认识，对介入前和术前影像学评估具有重要意义。在PPIA病例中，同侧椎动脉持续发育不良，大约75%的病例中，PPIA主要用于后窝的血管化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.