http://onlinelibrary.wiley.com/doi/10.1111/jon.12103/abstract?
Article first published online: 5 MAR 2014
DOI: 10.1111/jon.12103
Copyright © 2014 by the American Society of Neuroimaging
Issue
Journal of Neuroimaging
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Keywords:
- Leukoaraiosis;
- Circle Of Willis;
- MRA
ABSTRACT
BACKGROUND AND PURPOSE
The
Circle of Willis (COW) is the main collateral system between the
bilateral carotid systems and the posterior circulation. COW normal
variants are encountered in up to 62% of subjects. We hypothesize that,
in patients with carotid artery stenosis, the presence of COW variants
is a risk factor for leukoaraiosis.
MATERIALS AND METHODS
Forty-seven
patients (mean age 72.1 ± 9 years, males = 39) with carotid artery
stenosis admitted for carotid endarterectomy were included and underwent
an admission brain MRI/MRA. Two neuroradiologists evaluated the COW
variants. FLAIR-leukoaraiosis lesion-volume was performed using a
semiautomated segmentation technique. Mann–Whitney and Pearson
correlations were conducted to identify the correlation between the
FLAIR-leukoaraiosis lesion-volume and the COW variants. ROC analysis was
performed to evaluate the AUC of FLAIR-leukoaraiosis lesion-volume and
presence/absence of COW variants.
RESULTS
Pearson
correlation demonstrated that the leukoaraiosis lesion-volume is
significantly associated with the COW variants number (rho = .358, P
= .0215). When patients were dicotomized in two subgroups, with and
without COW variants, the lesion-volume was significantly higher in the
variants group (P = .0405). The ROC curve analysis showed an AUC of .688 (SE = .083, 95%CI = .525-.823) with a statistically significant P = .0225, between the presence of COW variants and the FLAIR-leukoaraiosis lesion-volume.
CONCLUSION
The
presence and the number of COW variants are associated with a higher
leukoaraiosis volume in patients with significant internal carotid
artery stenosis.
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