Circle of Willis anatomical variants - disease or the norm?

Congress:

ECR 2020

Poster Number:

C-12476

Type:

Scientific Exhibit

Keywords:

Vascular, Neuroradiology brain, MR-Angiography, Computer Applications-Detection, diagnosis, Radiobiology, Developmental disease, Image verification, Prospective, Observational, Performed at one institution

Authors:

J. Sidorova, A. I. Gromov, A. Kudryavtseva, M. Starodubtseva; Moscow/RU

DOI:

10.26044/ecr2020/C-12476

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-12476

Fig. 1: Measuring sample. Cerebral atrophy: a) Ax T2 convex sulcus width. b) Sag T2...

Fig. 2: Axial T2 FLAIR on different levels (a, b). Hyperintense vascular foci (arrows),...

Methods and materials

71 patients 03.02.19-25.09.19 examined by brain MRI+angiography according to protocol [1]:

Neuro MR-protocol:

• axial T2 spin-echo

• axial T2 fluid-attenuated inversion recovery (FLAIR)

• sagittal T2 fast-spin-echo (FSE)

• coronal T1 FLAIR

• 3D time-of-flight (TOF) gradient-echo (GRE)

Liquor spaces, reflecting the degree of atrophic changes were measured in each patient (fig 1).

Cerebral measurements parameters:

• Cerebral atrophy: maximal width of convex sulcus on Ax T2 + parietal space on Sag T2 (mm).

• Cerebellar atrophy: maximal width of cerebellar sulcus + сerebellopontine cistern (mm).

• Cisternal atrophy: maximal Superior cerebellar cistern width + Interpeduncular cistern (mm).

• Internal atrophy: ventricular-cranial index (VCI) - anterior ventricles horns width/inter-temporal dimension (in percent)

Fig. 1: Measuring sample. Cerebral atrophy: a) Ax T2 convex sulcus width. b) Sag T2 parietal space width. Cerebellar atrophy: с) Сerebellar sulcus width. d) сerebellopontine cistern width. Cisternal atrophy: e) Superior cerebellar cistern width. f) Interpeduncular cistern width.

Vascular brain changes graded by levels by scale (table 1), (fig 2).

Brain vascular changes scale. Table 1

changes	level
*Single vascular foci on T2 FLAIR up to 3*	1
*Single foci from 3 to 10*	2
*Multiple foci more than 10*	3
*Leukoaraiosis +-foci*	4
*lacunar cyst*	5
*Post-stroke changes*	6

Fig. 2: Axial T2 FLAIR on different levels (a, b). Hyperintense vascular foci (arrows), periventricular leukoaraiosis (arrowhead).

Patients were asked to determine the level of headache in scores on a standard ten-point scale and fill out a questionnaire. The number of complaints was considered (table 2).

Patient questionnaire. Table 2

Table 1

The data were statistically processed in Excel using descriptive statistics.