title: Correlation between leukoaraiosis volume and circle of Willis variants.
abstract: OBJECTIVE
  The Circle of Willis (COW) is the main collateral system between the bilateral carotid systems and the posterior circulation. COW normal variants are encountered in up to 62% of subjects. We hypothesize that, in patients with carotid artery stenosis, the presence of COW variants is a risk factor for leukoaraiosis.
  
  
  METHODS
  Forty-seven patients (mean age 72.1 ± 9 years, males = 39) with carotid artery stenosis admitted for carotid endarterectomy were included and underwent an admission brain MRI/MRA. Two neuroradiologists evaluated the COW variants. FLAIR-leukoaraiosis lesion-volume was performed using a semiautomated segmentation technique. Mann-Whitney and Pearson correlations were conducted to identify the correlation between the FLAIR-leukoaraiosis lesion-volume and the COW variants. ROC analysis was performed to evaluate the AUC of FLAIR-leukoaraiosis lesion-volume and presence/absence of COW variants.
  
  
  RESULTS
  Pearson correlation demonstrated that the leukoaraiosis lesion-volume is significantly associated with the COW variants number (rho = .358, P = .0215). When patients were dicotomized in two subgroups, with and without COW variants, the lesion-volume was significantly higher in the variants group (P = .0405). The ROC curve analysis showed an AUC of .688 (SE = .083, 95%CI = .525-.823) with a statistically significant P = .0225, between the presence of COW variants and the FLAIR-leukoaraiosis lesion-volume.
  
  
  CONCLUSIONS
  The presence and the number of COW variants are associated with a higher leukoaraiosis volume in patients with significant internal carotid artery stenosis.
authors.affiliation: Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato s.s. 554 Monserrato (Cagliari) 09045, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Saba
authors.affiliation: Department of Radiology, New York University School of Medicine, New York, USA.|Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.
authors.forename: Eytan
authors.initials: E
authors.lastname: Raz
authors.affiliation: Department of Radiology, New York University School of Medicine, New York, USA.
authors.forename: Girish
authors.initials: G
authors.lastname: Fatterpekar
authors.affiliation: Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554 Monserrato (Cagliari) 09045, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Montisci
authors.affiliation: Department of Radiological Sciences, Oncology and Anatomical Pathology "Sapienza", Università di Roma, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: di Martino
authors.affiliation: Department of Cardiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554 Monserrato (Cagliari) 09045, Italy.
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Bassareo
authors.affiliation: Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato s.s. 554 Monserrato (Cagliari) 09045, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Piga
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000150:complications* / Q000473:pathology*; D002941:Circle of Willis / Q000002:abnormalities* / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D049292:Leukoaraiosis / Q000209:etiology* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009929:Organ Size; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Circle Of Willis; Leukoaraiosis; MRA