Distribution of cerebral blood flow in the nucleus caudatus, nucleus lentiformis, and thalamus: a study of territorial arterial spin-labeling MR imaging.
OBJECTIVE
To investigate the effect of variations in anatomic features of the circle of Willis on the perfusion territory to deep structures, including the nucleus caudatus, the nucleus lentiformis, and the thalamus.


METHODS
The ethics committee of the study institution approved the study protocol. A total of 159 patients with first-time clinical symptoms of cerebral ischemia were recruited. Contributions to the perfusion territory were visualized with territorial arterial spin-labeling magnetic resonance (MR) imaging. The anatomic features of the circle of Willis were evaluated with time-of-flight MR angiography. Perfusion territory contributions were compared among circle of Willis variants by using the Cochran-Mantel-Haenszel test.


RESULTS
The perfusion territory contributions to the deep-brain structures could be evaluated in 119 of 159 patients (75%). With a fetal-type circle of Willis (41 of 238 hemispheres; 17%), there was a contribution from the ipsilateral internal carotid artery to the thalamus in all 41 hemispheres (100%), compared with 96 of the 197 hemispheres (49%) without a fetal-type circle of Willis. In the 19 patients with a hypoplastic A1 segment, there was more often a contribution of the contralateral internal carotid artery to the perfusion of the nucleus caudatus (10 of 19; 53%) and the nucleus lentiformis (5 of 19; 26%).


CONCLUSIONS
The perfusion territory contributions to deep-brain structures vary widely. These differences can be partly explained by variations in the anatomic features of the circle of Willis. (c) RSNA, 2010.
Hendrikse
Jeroen
J
Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Petersen
Esben Thade
ET
Chng
Soke Miang
SM
Venketasubramanian
Narayanaswamy
N
Golay
Xavier
X
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002421:Caudate Nucleus / Q000098:blood supply*; D002560:Cerebrovascular Circulation; D003342:Corpus Striatum / Q000098:blood supply*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D016015:Logistic Models; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013113:Spin Labels; D013788:Thalamus / Q000098:blood supply*
D013113:Spin Labels