Anat Cell Biol.  2023 Sep;56(3):360-366. 10.5115/acb.22.242.

Morphology of middle cerebral artery using computed tomography angiographic study in a tertiary care hospital

• Sharma U
• Verma S
• Adithan S

• KMID: 2546464
• DOI: http://doi.org/10.5115/acb.22.242

Abstract

Increased tortuosity of vessel is associated with high incidence of plaque formation leading to atherosclerosis. Surgical procedures are done after analyzing morphology of middle cerebral artery (MCA). However, literature describing MCA morphology using computed tomography angiography (CTA) is limited, so this study was planned to determine its incidence in Indian population. Datasets of CTA from 289 patients (180 males and 109 females), average age: 49.29±16.16 years (range: 11 to 85 years), from a tertiary care hospital were systematically reviewed for morphology of MCA. Cases involving aneurysms and infarcts were excluded. Four shapes of MCA were recognized: straight, U, inverted U, and S-shaped. MCA was straight in 44% (254/578), U-shaped in 37% (215/578), S shaped in 15% (89/578) and inverted U-shaped in 3% (20/578) cases. In males, MCA was straight in 46% (166/360), U-shaped in 37% (134/360), S-shaped in 16% (58/360) and inverted U-shaped in 4% (14/360) cases. In females, MCA was straight in 42% cases (92/218), U-shaped in 37% (81/218), S-shaped in 17% (36/218) and inverted U-shaped in 4% (9/218). On comparing shape with various age groups using chi square test, U shaped (P≤0.001) and S-shaped (P=0.003) MCA were found to be statistically significant. The incidence of straight shape was higher in advanced age group (>60 years). Knowledge of MCA shape will be useful for clinicians and surgeons in successful endovascular recanalization. Also, this data would help surgeons during neurointerventional procedures.

Keyword

Middle cerebral artery; Plaque; Aneurysm; Cerebral angiography

Figure

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  Fig. 1 VRT images (3D) and schematic diagrams showing shapes of middle cerebral artery. (A) Straight shape. (a) VRT image (3D) showing bilateral straight-shaped middle cerebral artery on both sides. White arrow: single trunk middle cerebral artery. (b) Schematic diagram showing bilateral straight-shaped middle cerebral artery on both sides. Blue arrow: single trunk middle cerebral artery. (B) U-shape. (a) VRT image (3D) showing unilateral U-shaped middle cerebral artery on left side. (b) Schematic diagram showing U-shaped middle cerebral artery on left side. Blue arrow: U-shaped middle cerebral artery. (C) Inverted U-shape. (a) VRT image (3D) showing inverted U-shaped middle cerebral artery on right side. Yellow arrow: Inverted U-shaped middle cerebral artery. (b) Schematic diagram showing inverted U-shaped middle cerebral artery on right side. Blue arrow: Inverted U- shaped middle cerebral artery. (D) S-shape. (a) VRT image (3D) showing S-shaped middle cerebral artery on right side. Pink arrow: S-shaped middle cerebral artery. (b) Schematic diagram showing S-shaped middle cerebral artery on right side. Blue arrow: S-shaped middle cerebral artery. VRT, volume rendered technique; R, right; L, left; ACA, anterior cerebral artery, MCA, middle cerebral artery.

Reference

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