Rofo 2010; 182 - A3
DOI: 10.1055/s-0029-1246589

Perfusion territories of the deep brain structures: territorial arterial spin labeling MRI at 3.0 Tesla fieldstrength.

J Hendrikse 1, ET Petersen 2, 3, SM Chng 2, N Venketasubramanian 4, X Golay 2, 5
  • 1Department of Radiology, University Medical Center Utrecht, The Netherlands
  • 2Department of Neuroradiology, National Neuroscience Institute, Singapore
  • 3CFIN, Department of Neuroradiology, Aarhus University Hospital, Denmark
  • 4Department of Neurology, National Neuroscience Institute, Singapore
  • 5Laboratory of Molecular Imaging, Singapore Bioimaging Consortium, Singapore

Purpose: Anatomical variations of the circle of Willis are known to influence the distribution of cerebral blood flow to cortical brain regions. The aim of the present study is to investigate the effect of variations in the circle of Willis anatomy on the perfusion territory to the nucleus caudatus, nucleus lentiformis and the thalamus.

Materials and methods: The ethics committee of our institution approved the study protocol. A total of 159 patients with first time clinical symptoms of cerebral ischemia were recruited. Perfusion territory contributions were visualized with territorial arterial spin labeling (TASL) Magnetic Resonance Imaging (MRI). The anatomy of the circle of Willis was evaluated with time-of-flight MR angiography. Perfusion territory contributions were compared between circle of Willis variants with a Cochran-Mantel-Haenszel test.

Results: The perfusion territory contributions to the deep brain structures could be evaluated in 119 patients. In patients with a fetal type circle of Willis, there was a contribution from the ipsilateral internal carotid artery (ICA) to the thalamus in all 41 hemispheres (100%), compared to 96 of the 197 hemispheres (49%) without a fetal type circle of Willis. In patients with a hypoplastic A1 segment, there was more often a contribution of the contralateral ICA to the perfusion of the nucleus caudatus and the nucleus lentiformis.

Conclusion: A large variation is present in the perfusion territory contributions to the deep brain structures, which can be partly explained by variations in the anatomy of the circle of Willis.