Relationship Between Variation Of Willis Circle And White Matter Lesions In Patients With Internal Carotid Artery Stenosis

Objective: As a clinically common cerebral small vessel disease,White matter lesion(WML)are closely related to the occurrence,development and prognosis of ischemic cerebrovascular disease.This study evaluated the scores of WML at different sites of brain and the variation of the Willis circle in patients with internal carotid artery stenosis,investigated the correlation between the variation of Willis circle and WML,and discussed the correlation between the variation of Willis circle and WML in patients with internal carotid artery stenosis under different background of Willis circle.In order to study the importance of Willis circle in balancing intracranial blood flow.Methods: A total of 123 patients was enrolled in this study from December,2015 to December,2017.Demographic(age,gender)and history of disease(Hypertension,coronary heart disease,hyperlipidemia,diabetes history),lifestyle(smoking,drinking history)of patients were collected.According to the patient's brain MRA and/or cranial CTA,all patients were divided into complete Willis circle group(43 patients)and variation of Willis circle group(80 patients).The variation of Willis circle including vasculature of Willis circle and vascular dysplasia Willis circle.Compared two groups' demographic,clinical data,lifestyle and past history,and analyzed the risk factors of the variation of Willis circle.According to the MRI performance,all patients were assessed by Fazekas scale,compared the WML scores of different sites of the brain in two groups,analyzed the correlation between variation of Willis circle and WML.Finally,we analyzed the scores of WML in the stenosis side and non-stenosis side of the internal carotid artery of two groups,analyzed the correlation between the carotid artery stenosis and WML in a setting of different structures of the Willis circle.Results: Compared with complete Willis circle group,age,sex(male),and hyperlipidemia were significantly higher in the variation of Willis circle group.In the variation of Willis circle group,hypertension,diabetes,coronary heart disease,smoking history,drinking history,were higher than complete Willis circle group,but the difference was not statistically significant.Logistic regression analysis showed that age,sex,and hyperlipidemia was the risk factor for variation of Willis circle.WML scores were significantly higher in the variation of Willis circle group than complete Willis circle group(8.43±2.19>6.02±1.08).The difference was statistically significant(P<0.05).In the variation of Willis circle group,WML scores were significantly higher in the side of internal carotid artery stenosis than non-stenosis side of the internal carotid artery(5.54±0.67>3.49±0.97).The difference was statistically significant(P>0.05).In the compelet of Willis circle group,the WML score of the stenosis side of the internal carotid artery has a tendency to increase compared with the non-stenosis side of the internal carotid artery(3.09±0.92>2.93±1.08),but there was no significant difference(P>0.05).Conclusions:(1)There was a relevance between age,gender(male),hyperlipidemia,and variation of Willis circle.(2)There was a significant correlation between variation of Willis circle and WML in patients with internal carotid artery stenosis.(3)In the variation of Willis circle group,there was a statistically significant difference in the WML score between the stenotic side and the non-stenosis side of the internal carotid artery.In the complete Willis circle group,there was no statistical difference in the WML score between the stenotic side and the non-stenosis side of the internal carotid artery.Description that the variation of Willis circle plays an important role in balancing intracranial blood flow.