| ObjectivePurposes of the present study were to evaluate the collateral pathways of internal carotid artery (ICA) severe stenosis or occlusion on digital subtract angiography (DSA) and magnetic resonance angiography (MRA),and to analyze the relationship between the collateral pathways and clinical manifestation. Materials and MethodsSeventy-four patients with ICA stenosis or occlusion were diagnosed determinately by DSA or MRA.Thirty-four patients were checked by DSA,thirty patients by MRA,in which were divided into the unilateral and bilateral stenosis or occlusive groups,ten patients by both DSA and MRA. Sixty persons who had normal findings on DSA or MRA served as the control group. We analyzed DSA,MRA,MRI,CT findings and clinical materials in the two groups,and counted the sorts and the presence rate of collateral pathways,and measured the diameter of the cerebral vessels,and studied the relationship between the sorts and presences of collateral pathways and changes in their diameters and clinical significance. ResultsSevere stenosis or occlusion of over fork of ICA and their mainbranchs were showed clearly in all patients in various degrees on DSA or MRA. In all cases,unilateral occlusive lesions were showed in thirty-eight patients,bilateral lesion in thirty-six patients. There were forty-five patients with Moyamoya disease,seventeen patients with cerebral arterial atherosclerosis,and twelve patients with the iatrogenic occlusion by operation or interventional radiology. On MRI and CT,cerebral hemorrhage was showed in thirty-five patients,cerebral infraction in sixteen patients,cerebral atrophy in eight patients,and normal findings in fifteen patients.On DSA,the presence rate of ipsilateral posterior communicating artery (PCoA) between the study group and the control group had no significant difference;on MRA the rate in the study group was higher significantly than the control group (P<0.01). On DSA and MRA,the diameter of ipsilateral PCoA in the study group was larger than the control group (P<0.01). On DSA,the presence rate of OPhA in the study group did not differ significantly from the control group,but its diameter was larger than the control group (P<0.05);on MRA,its presence rate is lower than the control group. The presence rate of anterior communicating artery (ACoA) in the study group,there was no statistical significance between on DSA and on MRA. On DSA,the presence rate and diameter of AchA were no significant difference between the study group and the control group (P>0.05). Collateral flow in PCoA,leptomeningeal anastomosis were supplied by ICA system or basal arterial system according to the different sites of stenosis or occlusion.The presence rate of ACoA in the unilateral group on DSA and MRA was higher significantly than in the bilateral group (P<0.05);there was no significant difference in that of PCoA between the two groups (P>0.05). On DSA,the presence rate of OPhA in the unilateral and bilateral groups had no significant difference;the augment rate in the bilateral group was higher significantly than in the unilateral group (P<0.05). The presence rate ofleptomeningeal anastomosis in the bilateral group was higher significantly than the unilateral group on DSA and MRA (P<0.01).In forty-five patients with Moyamoya disease,the presence rate of the anterior and the posterior moyamoya vessels on basal ganglion area were 89% and 37.85% respectively. Anterior choroids artery was showed in 49.2% of all patients on DSA,argument rate was 7.9%. The presence rate of dilated dural anastomosis was 19.1% and 6.8% respectively on DSA and MRA,dilated middle meningeal artery were showed.In the control group,the presence rate of PCoA> OPhA on DSA were significantly higher than on MRA,while that of ACoA on MRA was higher than on DSA. The diameter of PCoA and OPhA had no significant difference between on DSA and on MRA (P>0.05). In the study group,the presence rate of PCoA on DSA was significantly higher than on MRA (P<0.05),that of OPhA,ACoA and leptomeningeal anastomos...
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