IMR Press / JIN / Volume 21 / Issue 1 / DOI: 10.31083/j.jin2101002
Open Access Original Research
Association between symptomatic intracranial atherosclerotic disease and the integrity of the circle of Willis
Yilan Xu1Dongye Li2Wei Dai3,4Zhuozhao Zheng1,*,†Xihai Zhao1,5,*,†
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1 Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 102218 Beijing, China
2 Department of Radiology, Sun Yat-sen Memorial hospital, Sun Yat-sen Universitye, 510123 Guangzhou, Guangdong, China
3 Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, 100048 Beijing, China
4 Department of Neurology, Chinese PLA General Hospital & Medical School of Chinese PLA, 100039 Beijing, China
5 Department of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua University School of Medicine, 100084 Beijing, China
*Correspondence: zzza00509@btch.edu.cn (Zhuozhao Zheng); xihaizhao@tsinghua.edu.cn (Xihai Zhao)
These authors contributed equally.
J. Integr. Neurosci. 2022, 21(1), 2; https://doi.org/10.31083/j.jin2101002
Submitted: 26 August 2021 | Revised: 26 October 2021 | Accepted: 19 November 2021 | Published: 20 January 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

The relationship between the severity of intracranial atherosclerotic disease and the circle of Willis integrity is unclear. In this brief report, we investigate the associations between symptomatic intracranial atherosclerotic disease and the integrity of the circle of Willis. Patients with symptomatic intracranial atherosclerosis were enrolled and underwent intracranial artery magnetic resonance vessel wall imaging and time-of-flight angiography. The presence or absence of an intracranial atherosclerotic plaque and its maximum wall thickness and stenosis were evaluated. The presence or absence of the A1 segment of the bilateral anterior cerebral arteries (from the internal carotid artery to the anterior communicating artery segment is called anterior cerebral artery A1 segment), and anterior communicating artery, the P1 segment of the bilateral posterior cerebral arteries (The P1 segment of the posterior cerebral artery is a horizontally outward segment), and bilateral posterior communicating arteries were determined. The associations of the intracranial plaque features with the integrity of the circle of Willis were analyzed. Of the 110 recruited subjects (57.2 ± 11.1 years; 65% males), 51 had intracranial plaques, and 44 had stenosis. In patients with bilateral A1 and P1 segments (n = 85), intracranial stenosis was more severe in patients with an anterior communicating artery than those without an anterior communicating artery (19.7% ± 21.7% vs. 1.4% ± 3.3%, p = 0.046). In patients with bilateral A1 and P1 segments and an anterior communicating artery (n = 79), intracranial stenosis was more severe in patients with posterior communicating arteries than those without posterior communicating arteries (27.9% ± 23.7% vs. 13.5% ± 17.9%, p = 0.007). The odds ratio of intracranial stenosis was 1.214 (95% confidence interval (CI), 1.054–1.398; p = 0.007) in discriminating for the presence of posterior communicating arteries in patients with bilateral A1 and P1 segments and an anterior communicating artery after adjusting for confounding factors. The severity of intracranial atherosclerosis was independently associated with the presence of posterior communicating arteries in patients with a complete anterior part of the circle of Willis.

Keywords
Intracranial artery
Atherosclerosis
Circle of Willis
Magnetic resonance imaging
Vessel wall
Neurovascular
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