TITLE:
Radio-Anatomical Study of Anterior Variants of the Polygon of Willis
AUTHORS:
Diop Aboulaye Dione, Mar Ndeye Bigué, Diouf Joseph Coumba Ndofféne, Diop Sokhna Ba
KEYWORDS:
Polygon of Willis, Anamicals Variants, Vascular Diseases
JOURNAL NAME:
Open Journal of Radiology,
Vol.13 No.4,
November
15,
2023
ABSTRACT: The anterior system of the polygon of Willis plays an anastomotic role between the carotid territories and communicates with the posterior system. It ensures adequate cerebral blood flow in the event of internal occlusion. Its ability to redistribute blood flow depends on its morphology, the presence and size of the vessels that constitute it and their variants, knowledge of which is essential. The morphology of the carotid system is not constant and a number of variants are well recognized with greater hemodynamic importance. In this context, we undertook this work which aims to seek the anatomical variants of the anterior part of the PW; to determine the diameters of the vessels of the latter and to correlate these results with epidemiological data. We carried out a retrospective, descriptive and analytical study over a period of 4 months at Fann University Hospital, targeting patients who had undergone brain MRI with a 3D TOF sequence whatever the indication. Patients with lesions of cerebrovascular pathologies such as ischemia, hemorrhage, aneurysm, arteriovenous malformations or presenting a limited analysis examination due to the presence of kinetic or other artifact, were not included. Demographic data and anatomical variants were studied as well as the measurements of any continuous arterial segment greater than 0.8 mm in diameter. Those less than 0.8 mm in diameter were considered hypoplastic. The C3 segment of the internal carotid arteries, the A1 segment of the anterior cerebral arteries, the anterior communicating artery, constituted our main measurement sites. The sex ratio was 1.06, the mean age of the patients was 43 years ± 17.9 with extremes of 11 and 85 years. The anterior configuration of the polygon was complete in 57.5% representing 50% of men and 65.5% of women, in 56% of subjects under 40 years old and 58% in subjects over 40 years old. We noted a predominance of type a in 47% of patients followed by type g found in 35% of patients. The morphology of the anterior system of the Willis polygon is a function of its variants, some of which have greater hemodynamic importance than others. Its knowledge is essential for the management of cerebrovascular diseases.