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Radio-Anatomical Study of Anterior Variants of the Polygon of Willis

DOI: 10.4236/ojrad.2023.134019, PP. 185-194

Keywords: Polygon of Willis, Anamicals Variants, Vascular Diseases

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Abstract:

The anterior system of the polygon of Willis plays an anastomotic role between the carotid territories and communicates with the posterior system. It ensures adequate cerebral blood flow in the event of internal occlusion. Its ability to redistribute blood flow depends on its morphology, the presence and size of the vessels that constitute it and their variants, knowledge of which is essential. The morphology of the carotid system is not constant and a number of variants are well recognized with greater hemodynamic importance. In this context, we undertook this work which aims to seek the anatomical variants of the anterior part of the PW; to determine the diameters of the vessels of the latter and to correlate these results with epidemiological data. We carried out a retrospective, descriptive and analytical study over a period of 4 months at Fann University Hospital, targeting patients who had undergone brain MRI with a 3D TOF sequence whatever the indication. Patients with lesions of cerebrovascular pathologies such as ischemia, hemorrhage, aneurysm, arteriovenous malformations or presenting a limited analysis examination due to the presence of kinetic or other artifact, were not included. Demographic data and anatomical variants were studied as well as the measurements of any continuous arterial segment greater than 0.8 mm in diameter. Those less than 0.8 mm in diameter were considered hypoplastic. The C3 segment of the internal carotid arteries, the A1 segment of the anterior cerebral arteries, the anterior communicating artery, constituted our main measurement sites. The sex ratio was 1.06, the mean age of the patients was 43 years ± 17.9 with extremes of 11 and 85 years. The anterior configuration of the polygon was complete in 57.5% representing 50% of men and 65.5% of women, in 56% of subjects under 40 years old and 58% in subjects over 40 years old. We noted a predominance of type a in 47% of patients followed by type g found in 35% of patients. The morphology of the anterior system of the Willis polygon is a function of its variants, some of which have greater hemodynamic importance than others. Its knowledge is essential for the management of cerebrovascular diseases.

References

[1]  Eastcott, H.H.G. (1994) The Beginning of Stroke Prevention by Surgery. Cardiovascular Surgery, 2, 164-169.
[2]  William, P., Bannister, L., Berry, M., Dyson, M., Dussek, J.E. and Ferguson, M.W. (1995) Gray’s Anatomy. 38th Edition.
[3]  Miralles, M., Dolz, J.L., Cotillas, J., Aldoma, J., Santisa, M.A., Gimenez, A., et al. (1995) The Role of the Circle of Willis in Carotid Occlusion: Assessment with Phase Contrast MR Angiography and Transcranial Duplex. European Journal of Vascular and Endovascular Surgery, 10, 424-430.
https://doi.org/10.1016/S1078-5884(05)80164-9
[4]  Hillen, B. (1986) The Variability of the Circle of Willis: Univariate and Bivariate Analysis. Acta morphologica Neerlando-Scandinavica, 24, 87-101.
[5]  Krabbe-Hartkamp, M.J., Van der Grond, J., De Leuw, F.E., et al. (1998) Circle of Willis: Morphologic Variation on Three-Dimensional Time of Flight MR Angiograms. Radiology, 207, 103-111.
https://doi.org/10.1148/radiology.207.1.9530305
[6]  Macchi, C., Catini, C., Federico, C., Gulisano, M., Pacini, P., Cecchi, F., et al. (1996) Magnetic Resonance Angiographic Evaluation of Circulus Arteriosus Cerebri (Circle of Willis): A Morphologic Study in 100 Human Healthy Subjects. Italian Journal of Anatomy and Embryology, 101, 115-123.
[7]  Barboriak, D.P. and Provenzale, J.M. (1997) Pictorial Review: Magnetic Resonance Angiography of Arterial Variants at the Circle of Willis. Clinical Radiology, 52, 429-436.
https://doi.org/10.1016/S0009-9260(97)80003-7
[8]  Hoksbergen, A.W.J., Legemate, D.A., Csiba, L., Csàti, G., Siro, P. and Fulesdi, B. (2003) Absent Collateral Function of the Circle of Willis as Risk Factor for Ischemic Stroke. Cerebrovascular Diseases, 16, 191-198.
https://doi.org/10.1159/000071115
[9]  Krabbe-Hartkamp, M.J. and Van der Grond, J. (2000) Investigation of the Circle of Willis Using MR Angiography. Medicamund, 44, 20-27.
[10]  Chen, H.W., Yen, P.S., Lee, C.C., et al. (2004) Magnetic Resonance Angiographic Evaluation of the Circle of Willis in General Population: A Morphologic Study in 507 Cases. Chinese Journal of Radiology, 29, 223-229.
[11]  Lee, J.H., Choi, C,G., Kim, D.K., et al. (2004) Relationship between Circle of Willis Morphology on 3D Time of Flight MR Angiograms and Transient Ischemia during Vascular Clamping of the Internal Carotid. Artery during Carotid Endarterectomy. American Journal of Neuroradiology, 25, 558-564.
[12]  Brunereau, L.O., Levy, C. and Arrive, L. (1995) Anatomie du polygone de Willis en 3D temps de vol avec analyse des partitions. Japanese Journal of Radiology, 76, 573-575.
[13]  Maaly, M. and Ismail, A. (2011) Three-Dimensional Magnetic Resonance Angiography of the Circle of Willis: Anatomical Variations in General Egyptian Population. The Egyptian Journal of Radiology and Nuclear Medicine, 42, 405-412.
https://doi.org/10.1016/j.ejrnm.2011.09.001
[14]  Keeranghat, P.P., Jadadeesan, D., Prakash, M.L. and Gupta, R. (2018) Evaluation of Normal Variants of Circle of Willis at MRI. International Journal of Research in Medical Sciences, 6, 1617-1622.
https://doi.org/10.18203/2320-6012.ijrms20181497
[15]  Hadhri, K., Zarrouk, B., Drissi, C., Bellil, M., Ben Salah, M. and Kooli, M. (2019) Variantes anatomiques du polygone de Willis en angiographie par résonance magnétique. Morphologie, 103, 102.
https://doi.org/10.1016/j.morpho.2019.09.057
[16]  Yeniçeri, I.O., Çullu, N., Deveer, M. and Yeniçeri, E.N. (2017) Circle of Willis Variations and Artery Diameter Measurements in the Turkish Population. Folia Morphologica, 76, 420-425.
https://doi.org/10.5603/FM.a2017.0004
[17]  Stefani, M.A., Schneider, F.L., Maronne, A.C., Severino, A.G., Jackowski Cortical, A.P. and Wallace, M.C. (2000) Anatomic Variations of Anterior Cerebral Artery Cortical Branches. Clinical Anatomy, 13, 231-236.
https://doi.org/10.1002/1098-2353(2000)13:4<231::AID-CA1>3.0.CO;2-T
[18]  Hafez, K.A., Afifi, N.M. and Saudi, F.Z. (2007) Anatomical Variations of the Circle of Willis in Males and Females on 3D MR Angiograms. The Egyptian Journal of Hospital Medicine, 26, 106-121.
https://doi.org/10.21608/ejhm.2007.17785
[19]  Horikoshi, T., Akiyama, I., Yamagata, Z., Sugita, M. and Nukui, H. (2002) Magnetic Resonance Angiographic Evidence of Sex-Linked Variations in the Circle of Willis and the Occurrence of Cerebral Aneurysms. Journal of Neurosurgery, 96, 697-703.
https://doi.org/10.3171/jns.2002.96.4.0697
[20]  Qiu, C., Zhang, Y., Xue, C., Jiang, S. and Zhang, W. (2015) MRA Study on Variation of the Circle of Willis in Healthy Chinese Male Adults. BioMed Research International, 2015, Article ID: 976340.
https://doi.org/10.1155/2015/976340
[21]  Hashemi, S.M., Mahmoodi, R. and Amirjamshidi, A. (2013) Variations in the Anatomy of the Willis Circle: A 3-Year Cross-Sectional Study from Iran (2006-2009). Are the Distributions of Variations of Circle of Willis Different in Different Populations? Result of an Anatomical Study and Review of Literature. Surgical Neurology International, 4, Article 65.
https://doi.org/10.4103/2152-7806.112185
[22]  Milisavljevic, M., Marinkovic, S. and Djordjevic, L. (1986) Anastomoses in the Territory of the Posterior Cerebral Arteries. Acta Anatomica, 127, 221-225.
https://doi.org/10.1159/000146286
[23]  EL Barhoun, E.N., Gledhill, S.R. and Pitman, A.G. (2009) Circle of Willis Artery Diameters on MR Angiography: An Australian Reference Database. Journal of Medical Imaging and Radiation Oncology, 53, 248-260.
https://doi.org/10.1111/j.1754-9485.2009.02056.x

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