中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
14期
6424-6429
,共6页
男(雄)性%磁共振成像%Willis环%变异
男(雄)性%磁共振成像%Willis環%變異
남(웅)성%자공진성상%Willis배%변이
Male%Magnetic resonance imaging%Willis circle%Variation
目的：探讨中外健康成年男性生理状态下 Willis 环形态及变异。方法对 MRI、磁共振血管成像（MRA）均无异常的2246名中国汉族成年男性及343名欧美成年男性白人健康受检者脑MRA图像进行回顾性分析，确定Willis环血管的发育情况及环的完整性。所有受检者均采用3D TOP MRA技术，根据Willis环的完整性及血管发育情况进行综合分型。结果中外受检者Willis环完整型、部分完整型及不完整型分别为：中国人12.24%、70.12%、17.63%；白人18.66%、67.64%、13.70%，中国人和白人Willis环形态分布上存在统计学差异（P<0.01）。中国人及白人前循环均以正常完整型（Ⅰ型）为主。大脑前动脉 A1段（ACA-A1）段发育变异率：中国人13.40%、白人7.29%，中国人ACA-A1段变异较白人多，存在统计学差异（P<0.01）；且A1段变异均右侧多于左侧，有统计学差异（P<0.01）。后循环不完整比例中国人、白人分别为：83.93%、78.72%，主要表现为不完整型（d和e型）。中国人后循环完整型比例比白人低（P<0.01），同时中国人及白人分别有438名、83名形成胚胎型大脑后动脉（FTP），中国人 FTP 所占比例较白人低（P<0.05）。结论健康受检者Willis环存在广泛变异，以后循环变异为主，主要表现为部分完整型。Willis环变异分布汉族男性中国人与欧美男性白人存在人种间差异。MRA能够较全面真实反映健康状态下Willis环的形态，为临床脑血管疾病治疗及预后可能提供部分参考信息。
目的：探討中外健康成年男性生理狀態下 Willis 環形態及變異。方法對 MRI、磁共振血管成像（MRA）均無異常的2246名中國漢族成年男性及343名歐美成年男性白人健康受檢者腦MRA圖像進行迴顧性分析，確定Willis環血管的髮育情況及環的完整性。所有受檢者均採用3D TOP MRA技術，根據Willis環的完整性及血管髮育情況進行綜閤分型。結果中外受檢者Willis環完整型、部分完整型及不完整型分彆為：中國人12.24%、70.12%、17.63%；白人18.66%、67.64%、13.70%，中國人和白人Willis環形態分佈上存在統計學差異（P<0.01）。中國人及白人前循環均以正常完整型（Ⅰ型）為主。大腦前動脈 A1段（ACA-A1）段髮育變異率：中國人13.40%、白人7.29%，中國人ACA-A1段變異較白人多，存在統計學差異（P<0.01）；且A1段變異均右側多于左側，有統計學差異（P<0.01）。後循環不完整比例中國人、白人分彆為：83.93%、78.72%，主要錶現為不完整型（d和e型）。中國人後循環完整型比例比白人低（P<0.01），同時中國人及白人分彆有438名、83名形成胚胎型大腦後動脈（FTP），中國人 FTP 所佔比例較白人低（P<0.05）。結論健康受檢者Willis環存在廣汎變異，以後循環變異為主，主要錶現為部分完整型。Willis環變異分佈漢族男性中國人與歐美男性白人存在人種間差異。MRA能夠較全麵真實反映健康狀態下Willis環的形態，為臨床腦血管疾病治療及預後可能提供部分參攷信息。
목적：탐토중외건강성년남성생리상태하 Willis 배형태급변이。방법대 MRI、자공진혈관성상（MRA）균무이상적2246명중국한족성년남성급343명구미성년남성백인건강수검자뇌MRA도상진행회고성분석，학정Willis배혈관적발육정황급배적완정성。소유수검자균채용3D TOP MRA기술，근거Willis배적완정성급혈관발육정황진행종합분형。결과중외수검자Willis배완정형、부분완정형급불완정형분별위：중국인12.24%、70.12%、17.63%；백인18.66%、67.64%、13.70%，중국인화백인Willis배형태분포상존재통계학차이（P<0.01）。중국인급백인전순배균이정상완정형（Ⅰ형）위주。대뇌전동맥 A1단（ACA-A1）단발육변이솔：중국인13.40%、백인7.29%，중국인ACA-A1단변이교백인다，존재통계학차이（P<0.01）；차A1단변이균우측다우좌측，유통계학차이（P<0.01）。후순배불완정비례중국인、백인분별위：83.93%、78.72%，주요표현위불완정형（d화e형）。중국인후순배완정형비례비백인저（P<0.01），동시중국인급백인분별유438명、83명형성배태형대뇌후동맥（FTP），중국인 FTP 소점비례교백인저（P<0.05）。결론건강수검자Willis배존재엄범변이，이후순배변이위주，주요표현위부분완정형。Willis배변이분포한족남성중국인여구미남성백인존재인충간차이。MRA능구교전면진실반영건강상태하Willis배적형태，위림상뇌혈관질병치료급예후가능제공부분삼고신식。
Objective To investigate the anatomic variation of Willis' Circle in Chinese and Caucasian healthy adult males in physiological status by magnetic resonance angiography(MRA). Methods The arterial developmental condition and integrity of Willis' circle in 2246 Chinese and 343 Caucasian cases with normal MRI and MRA was retrospectively analyzed. All cases were detected by 3D TOP MRA and synthetic typing was defined according to the arterial developmental condition and integrity of Willis' circle. Results The rate of the complete, partial complete and incomplete Willis' circle in Chinese cases was 12.24%,70.12%,17.63% and in Caucasian cases was 18.66%,67.64%,13.70% respectively. There were significant differences in morphology between Chinese and Caucasian cases(P<0.01). The normal complete anterior circulation type (Ⅰtype) was most popular in both Chinese and Caucasian cases. The rate of ACA-A1 variation was 13.40% in Chinese cases and 7.29% in Caucasian cases. There were significant differences in ACA-A1 variation between Chinese and Caucasian cases , also between the left and right. The variation of ACA-A1 variation in Chinese was more than in Caucsian(P<0.01), and the variation of right ACA-A1 was much more than the left(P<0.01). The rate of incomplete posterior circulation in Chinese and Caucasian cases was 83.93%, 78.72% respectively, and the types d and e were more common. The rate of complete posterior circulation in Chinese cases was lower than Caucasian cases(P<0.01), 438 Chinese cases and 83 Caucasian cases formed FTPs, and the rate of FTP in Chinese cases was lower than Caucasian cases(P<0.05). Conclusion Variation of Willis' circle is extensively present in Chinese and Caucasian healthy adult males, and the most variation existed in posterior circulation, presenting the partial complete type. Variation of Willis' Circle may be different in Chinese and Caucasian. MRA can actually reflect the morphology of Willis' Circle in physiological status, providing some reference information for clinical treatment and prognosis of cerebrovascular disease.
