Abstract：
Studies on patients suggest an association between anatomical variations in the Circle of Willis (CoW) and intracranial aneurysms (IA), but it is unclear whether this association is present in the general population. In this cross-sectional population study, we investigated the associations between CoW anatomical variations and IA.
We included 1667 participants from a population sample with 3 T MRI time-of-flight angiography (40-84 years, 46.5% men). Saccular IAs were defined as protrusions in the intracranial arteries ≥2 mm, while variants of the CoW were classified according to whether segments were missing or hypoplastic (< 1 mm). We used logistic regression, adjusting for age and IA risk factors, to assess whether participants with incomplete CoW variants had a greater prevalence of IA and whether participants with specific incomplete variants had a greater prevalence of IA.
Participants with an incomplete CoW had an increased prevalence of IA (OR, 2.3 [95% CI 1.05-5.04]). This was mainly driven by the variant missing all three communicating arteries (OR, 4.2 [95% CI 1.7-1 0.3]) and the variant missing the P1 segment of the posterior cerebral artery (OR, 3.6 [95% CI 1.2-10.1]). The combined prevalence of the two variants was 15.4% but accounted for 28% of the IAs.
The findings suggest that an incomplete CoW is associated with an increased risk of IA for adults in the general population.
We included 1667 participants from a population sample with 3 T MRI time-of-flight angiography (40-84 years, 46.5% men). Saccular IAs were defined as protrusions in the intracranial arteries ≥2 mm, while variants of the CoW were classified according to whether segments were missing or hypoplastic (< 1 mm). We used logistic regression, adjusting for age and IA risk factors, to assess whether participants with incomplete CoW variants had a greater prevalence of IA and whether participants with specific incomplete variants had a greater prevalence of IA.
Participants with an incomplete CoW had an increased prevalence of IA (OR, 2.3 [95% CI 1.05-5.04]). This was mainly driven by the variant missing all three communicating arteries (OR, 4.2 [95% CI 1.7-1 0.3]) and the variant missing the P1 segment of the posterior cerebral artery (OR, 3.6 [95% CI 1.2-10.1]). The combined prevalence of the two variants was 15.4% but accounted for 28% of the IAs.
The findings suggest that an incomplete CoW is associated with an increased risk of IA for adults in the general population.
摘要：
目的：对患者的研究表明，威利斯环（CoW）的解剖变异与颅内动脉瘤（IA）之间存在关联，但目前尚不清楚这种关联是否存在于普通人群中.在这项横断面人口研究中，我们调查了CoW解剖变异与IA之间的关联。
方法：我们纳入了来自3TMRI飞行时间血管造影的人群样本的1667名参与者（40-84年，46.5%的男性）。囊状IAs被定义为颅内动脉中≥2mm的突起，而CoW的变体根据节段缺失或发育不良（<1mm）进行分类。我们使用逻辑回归，调整年龄和IA危险因素，评估CoW变异不完全的参与者是否有更高的IA患病率,以及特定不完全变异的参与者是否有更高的IA患病率.
结果：CoW不完整的参与者IA患病率增加（OR，2.3[95%CI1.05-5.04]）。这主要是由缺少所有三个交通动脉的变体(OR，4.2[95％CI1.7-10.3]）和缺少大脑后动脉P1段的变体（OR，3.6[95%CI1.2-10.1])。两种变体的合并患病率为15.4%，但占IAs的28%。
结论：研究结果表明，在普通人群中，不完全CoW与成年人IA风险增加相关。
方法：我们纳入了来自3TMRI飞行时间血管造影的人群样本的1667名参与者（40-84年，46.5%的男性）。囊状IAs被定义为颅内动脉中≥2mm的突起，而CoW的变体根据节段缺失或发育不良（<1mm）进行分类。我们使用逻辑回归，调整年龄和IA危险因素，评估CoW变异不完全的参与者是否有更高的IA患病率,以及特定不完全变异的参与者是否有更高的IA患病率.
结果：CoW不完整的参与者IA患病率增加（OR，2.3[95%CI1.05-5.04]）。这主要是由缺少所有三个交通动脉的变体(OR，4.2[95％CI1.7-10.3]）和缺少大脑后动脉P1段的变体（OR，3.6[95%CI1.2-10.1])。两种变体的合并患病率为15.4%，但占IAs的28%。
结论：研究结果表明，在普通人群中，不完全CoW与成年人IA风险增加相关。
