The Application of Cranio-Cervical CT Angiography in the Evaluation of Intracranial and Cervical Arterial Fenestration

Objective To evaluate the clinical value of cranio-cervical CT angiography in the diagnosis of intracranial and cervical artery fenestration.Methods 1042 cranio-cervical CT angiography(CTA) were retrospectively reviewed.All images were reconstructed with volume rendering,maximum intensity projection,multiplanar reconstruction and curve planar reconstruction.The fenestration's frequency,location,cranio-cervical CTA features,surrounding structures of lesions,and other associated vascular anomalies were analyzed.Results In 58 patients,61 fenestrations were detected.24The fenestrations were located in basilar artery in 24 cases,in vertebral artery in 16,in anterior cerebral artery in 12,in anterior communicating artery area in 7,and in middle cerebral artery in 2 cases.In 61 fenestrated arteries,42 of them were small with a slit-like shape,and 19 were relatively large with a convex-lens-like shape.In all fenestration patients,the lesions associated with intracranial aneurysms in 12 patients,hypoplastic vertebral artery in 8,fetal origin of the posterior cerebral artery in 10,and aberrant entrance position into the transverse foramen of the right vertebral artery in 1 case.Conclusion Cranio-cervical CTA can directly,clearly and exactly demonstrate the location,shape,and adjacent structures of intracranial and cervical arterial fenestration.Other associated vascular anomalies can also be demonstrated.It can help making therapeutic regimen for the associated vascular anomalies.