open access

Vol 72, No 4 (2013)
ORIGINAL ARTICLES
Published online: 2013-12-09
Submitted: 2013-05-18
Accepted: 2013-07-14
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Configurations of the circle of Willis: a computed tomography angiography based study on a Polish population

W. Klimek-Piotrowska, M. Kopeć, M. Kochana, R. M. Krzyżewski, K. A. Tomaszewski, P. Brzegowy, J. Walocha
DOI: 10.5603/FM.2013.0049
·
Folia Morphol 2013;72(4):293-299.

open access

Vol 72, No 4 (2013)
ORIGINAL ARTICLES
Published online: 2013-12-09
Submitted: 2013-05-18
Accepted: 2013-07-14

Abstract

The aim of the study was to investigate the distribution of the circle of Willis variants in Polish population by means of computed tomography angiography (CTA). The results were then analysed and compared with another study that used similar methods but that was carried out on an ethnically distinct population. Patients presenting with intracranial pathology were excluded from the initial study population. In total, 250 CTA belonging to 129 female and 121 male patients were reviewed. A modified classification system of the circle was proposed, which took into consideration the anterior and the posterior aspects of the circle individually. The typical variant of Willis’s circle occurred in 16.80% of cases. The anterior and the posterior portions of the circle were normal in 47.20% and 26.80% of the patients respectively. As forthe anterior part, lack of the anterior communicating artery was the most frequent abnormality (22.80%). Bilateral absence of posterior communicating arteries was the most common anomaly in the posterior part of the circle (29.20%). This type of anomaly was also the most common, when taking into consideration the entire circle (12.00%). There were statistically significant differences between the age groupsand genders when considering the occurrence of an incomplete circle. Overall, a substantial proportion of patients manifested clinically important variants that were incapable of providing collateral circulation. Comparison with other imaging-based and cadaveric studies revealed noticeable differences, that may have resulted from the variable technical features of other studies or other factors such as the ethnical origins of the studied populations.

Abstract

The aim of the study was to investigate the distribution of the circle of Willis variants in Polish population by means of computed tomography angiography (CTA). The results were then analysed and compared with another study that used similar methods but that was carried out on an ethnically distinct population. Patients presenting with intracranial pathology were excluded from the initial study population. In total, 250 CTA belonging to 129 female and 121 male patients were reviewed. A modified classification system of the circle was proposed, which took into consideration the anterior and the posterior aspects of the circle individually. The typical variant of Willis’s circle occurred in 16.80% of cases. The anterior and the posterior portions of the circle were normal in 47.20% and 26.80% of the patients respectively. As forthe anterior part, lack of the anterior communicating artery was the most frequent abnormality (22.80%). Bilateral absence of posterior communicating arteries was the most common anomaly in the posterior part of the circle (29.20%). This type of anomaly was also the most common, when taking into consideration the entire circle (12.00%). There were statistically significant differences between the age groupsand genders when considering the occurrence of an incomplete circle. Overall, a substantial proportion of patients manifested clinically important variants that were incapable of providing collateral circulation. Comparison with other imaging-based and cadaveric studies revealed noticeable differences, that may have resulted from the variable technical features of other studies or other factors such as the ethnical origins of the studied populations.
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Keywords

cerebral arterial circle, computed tomography angiography, anatomic variations

About this article
Title

Configurations of the circle of Willis: a computed tomography angiography based study on a Polish population

Journal

Folia Morphologica

Issue

Vol 72, No 4 (2013)

Pages

293-299

Published online

2013-12-09

DOI

10.5603/FM.2013.0049

Bibliographic record

Folia Morphol 2013;72(4):293-299.

Keywords

cerebral arterial circle
computed tomography angiography
anatomic variations

Authors

W. Klimek-Piotrowska
M. Kopeć
M. Kochana
R. M. Krzyżewski
K. A. Tomaszewski
P. Brzegowy
J. Walocha

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