Anatomic characteristics of the vertebrobasilar artery: A three-dimensional reconstruction study based on computed tomography angiography.

Abstract

The vertebrobasilar artery (VBA) exhibits substantial inter-individual variation that must be considered in diagnosis and surgical planning. We conducted 3-dimensional reconstruction of the bilateral VBA based on head and neck computed tomography angiography (CTA) to assess bilateral, individual, age-dependent, and sex-dependent differences in anatomical parameters. A retrospective study was performed. Individual 3-dimensional models of the VBA and skull were constructed and morphology evaluated based on head and neck CTA data from 199 adults. According to morphological and anatomical variation, the VBA was divided into 3 types: balanced, L, and S. The diameters and lengths of basilar and bilateral vertebral artery (VA) intracranial segments as well as VBA blending length, and bilateral distances of the vertebral arteries moving up the atlas were measured and statistically compared. The L-type was the most common VBA morphology, and anatomic type distribution differed significantly by age (P < .05). VA diameter was 3.34 ± 0.68 mm on the left side and 3.09 ± 0.71 mm on the right side, while bending length was 5.62 ± 3.35 mm on the left and 4.94 ± 3.41 mm on the right side. Balanced basilar arteries measured 3.41 ± 0.61 mm in diameter, 2.83 ± 0.33 cm in length, and 2.55 ± 2.45 mm in bending length. The L-type basilar artery measured 3.48 ± 0.71 mm in diameter, 3.06 ± 0.44 cm in length, and 2.78 ± 0.37 mm in bending length. Finally, S-type basilar arteries measured 3.84 ± 0.86 mm in diameter, 3.38 ± 0.61 cm in length, and 3.67 ± 4.39 mm in bending length. The distance traveled by the VA across the atlas differed significantly between left and right sides as well as between males and females (P < .05). The vertebrobasilar arteries in the general healthy population were successfully fused and 3-dimensionally reconstructed based on the CTA, and an observational study was conducted on their morphological and anatomical characteristics. Three-dimensional reconstruction of the VBA using CTA is feasible for anatomical research and also has diagnostic value for the variations and anatomical parameters of the VBA.