Sex-specific anatomical variation of circle of Willis arteries

•Circle of Willis (CoW) artery diameters are larger in men compared to women.•CoW anatomical variants differ between men and women.•CoW bifurcation angles are comparable between men and women. Anatomical variations in the circle of Willis (CoW) arteries are common and can affect hemodynamic stress,...

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Bibliographic Details
Published in:NeuroImage (Orlando, Fla.) Vol. 307; p. 121035
Main Authors: Groenheide, Phebe J., Vos, Iris N., Bülow, Robin, van der Schaaf, Irene C., Velthuis, Birgitta K., Ruigrok, Ynte M.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 15.02.2025
Elsevier Limited
Elsevier
Subjects:
Adolescent
Adult
Aged
Anatomic Variation
Anatomical variant
Angiography
Aplasia
Arteries
Bifurcation angle
Circle of Willis
Circle of Willis - anatomy & histology
Circle of Willis - diagnostic imaging
Classification
Female
Fetuses
Generalized linear models
Humans
Hypoplasia
Magnetic Resonance Angiography - methods
Male
Middle Aged
MR angiography
Pathology
Population studies
Radiology/Diagnostic Imaging
Regression analysis
Semi-automatic measurement
Sex Characteristics
Sex difference
Sex differences
Sexes
Variation
Veins & arteries
Women
Young Adult
Germany
Circle of Willis
GLM
CoW
Bifurcation angle
Pcom
FDR
F-PCA
IA
SHIP
ACA
VBJ
ICA
MCA
TOF
VA
Sex difference
DVA
PCA
Semi-automatic measurement
MR angiography
Anatomical variant
AVM
MRA
Acom
BA
arteriovenous malformation
basilar artery
posterior communicating artery
anterior cerebral arteries
vertebrobasilar junction
Generalized Linear Model
intracranial aneurysm
internal carotid artery
Time-of-Flight
false discovery rate
vertebral artery
posterior cerebral artery
Magnetic Resonance Angiography
fetal-type posterior cerebral artery
developmental venous anomaly
Study of Health in Pomerania
middle cerebral artery
anterior communicating artery
ISSN:1053-8119, 1095-9572, 1095-9572
Online Access:Get full text
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Summary:•Circle of Willis (CoW) artery diameters are larger in men compared to women.•CoW anatomical variants differ between men and women.•CoW bifurcation angles are comparable between men and women. Anatomical variations in the circle of Willis (CoW) arteries are common and can affect hemodynamic stress, thereby influencing the risk of cerebrovascular pathology. Previous studies have suggested sex differences in CoW anatomy, but findings vary due to limited study population size and different measurement methods. This study aims to investigate sex differences in artery diameters, anatomical variants and bifurcation angles of the CoW using a large population cohort and semi-automatic measurements. Sex-specific CoW anatomical variations were assessed using Magnetic Resonance Angiography (MRA) scans of 1,052 individuals without intracranial vascular abnormalities. Diameters and bifurcation angles of large CoW arteries (>1.2 mm) were measured with a semi-automatic tool. Diameters of smaller anterior communicating artery (Acom) and posterior communicating arteries (Pcoms) and the anatomical variants of the CoW were determined manually. Generalized Linear Models (GLMs) and logistic regression models with adjustments for covariates were used to compare anatomical variations between sexes. Men exhibited larger diameters in all semi-automatically measured CoW arteries. A complete anterior CoW was more prevalent in men than women, while there was no difference for the posterior CoW. Aplasia/hypoplasia of the Acom was more prevalent in women. Aplasia/hypoplasia of one Pcom was more common in women, while aplasia/hypoplasia of both Pcoms was more common in men. No sex differences were found in CoW bifurcation angles and in the occurrence of fetal-type posterior cerebral arteries. This study identified significant CoW differences in artery diameters and anatomical variants between sexes, while bifurcation angles between arteries were comparable. Future research should investigate the association between these sex-specific CoW variations and cerebrovascular pathology. [Display omitted]
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ISSN:1053-8119
1095-9572
1095-9572
DOI:10.1016/j.neuroimage.2025.121035