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<meta name="HW.identifier" content="/ajnr/45/11/1661.atom" />
<meta name="HW.pisa" content="ajnr;45/11/1661" />
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<meta name="DC.Language" content="en" />
<meta name="DC.Title" content="High-Resolution MRA Cerebrovascular Findings in a Tri-Ethnic Population" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8402" />
<meta name="DC.Date" content="2024-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2024 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Incidental findings on brain MRI and variations of the circle of Willis (CoW) are relatively common among the general population. Ethnic differences have been described before, but few studies have explored the prevalence of incidental intracranial cerebrovascular findings and CoW variants in the setting of a single multiethnic cohort. The purpose of this investigation was to describe both incidental cerebrovascular findings and the morphology of the CoW on high-resolution 3T TOF-MRA in a UK tri-ethnic population-based cohort and to present updated prevalence estimates and morphologic reference values.

MATERIALS AND METHODS: We studied participants from the UK Southall and Brent REvisited study who underwent 3T brain MRI between 2014 and 2018. TOF-MRA images were assessed for the presence of incidental cerebrovascular findings and used to determine CoW anatomy.

RESULTS: Seven hundred fifty participants (mean age, 71.28 [SD, 6.46] years; range, 46–90 years; 337 women), 322 White Europeans, 253 South Asians, and 175 African Caribbeans were included. Incidental cerebrovascular findings were observed in 84 subjects (11.2%, 95% CI, 9.0%–13.7%; 36 women; 42.86%, 95% CI, 32.11%–54.12%), with cerebral aneurysms being the most frequent followed by intracranial arterial stenoses with the highest prevalence among South Asians compared with White European (OR: 2.72; 95% CI, 1.22–6.08; P = .015) and African Caribbean subjects (OR: 2.79; 95% CI, 1.00–7.82; P = .051). Other findings included arteriovenous malformations and infundibula. The CoW was found to be more often complete in women than in men (25.22% compared with 18.41%, P = .024) and in African Caribbean (34.86%) compared with White European (19.19%) and South Asian (14.23%) subjects ( P &lt; .001 each).

CONCLUSIONS: Intracranial arterial stenoses were independently associated with ethnicity after adjusting for vascular risk factors, having the highest prevalence among South Asians. The prevalence of aneurysms was higher than that in previous population-based studies. We observed anatomic differences in the CoW configuration among women, men, and ethnicities.

ACA
:   anterior cerebral artery
AcomA
:   anterior comunicating artery
CoW
:   circle of Willis
CVM
:   cerebral vascular malformations
ICAS
:   intracranial arterial stenoses
PCA
:   posterior cerebral artery
PcomA
:   posterior communicating artery" />
<meta name="DC.Contributor" content="Rafael Rehwald" />
<meta name="DC.Contributor" content="Carole H. Sudre" />
<meta name="DC.Contributor" content="Lorna Smith" />
<meta name="DC.Contributor" content="Magdalena Sokolska" />
<meta name="DC.Contributor" content="Therese Tillin" />
<meta name="DC.Contributor" content="David Atkinson" />
<meta name="DC.Contributor" content="Nishi Chaturvedi" />
<meta name="DC.Contributor" content="Alun D. Hughes" />
<meta name="DC.Contributor" content="Hans Rolf Jäger" />
<meta name="article:published_time" content="2024-11-01" />
<meta name="article:section" content="Neurovascular/Stroke Imaging" />
<meta name="citation_title" content="High-Resolution MRA Cerebrovascular Findings in a Tri-Ethnic Population" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Incidental findings on brain MRI and variations of the circle of Willis (CoW) are relatively common among the general population. Ethnic differences have been described before, but few studies have explored the prevalence of incidental intracranial cerebrovascular findings and CoW variants in the setting of a single multiethnic cohort. The purpose of this investigation was to describe both incidental cerebrovascular findings and the morphology of the CoW on high-resolution 3T TOF-MRA in a UK tri-ethnic population-based cohort and to present updated prevalence estimates and morphologic reference values.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We studied participants from the UK Southall and Brent REvisited study who underwent 3T brain MRI between 2014 and 2018. TOF-MRA images were assessed for the presence of incidental cerebrovascular findings and used to determine CoW anatomy.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Seven hundred fifty participants (mean age, 71.28 [SD, 6.46] years; range, 46–90 years; 337 women), 322 White Europeans, 253 South Asians, and 175 African Caribbeans were included. Incidental cerebrovascular findings were observed in 84 subjects (11.2%, 95% CI, 9.0%–13.7%; 36 women; 42.86%, 95% CI, 32.11%–54.12%), with cerebral aneurysms being the most frequent followed by intracranial arterial stenoses with the highest prevalence among South Asians compared with White European (OR: 2.72; 95% CI, 1.22–6.08; &lt;i&gt;P&lt;/i&gt; = .015) and African Caribbean subjects (OR: 2.79; 95% CI, 1.00–7.82; &lt;i&gt;P&lt;/i&gt; = .051). Other findings included arteriovenous malformations and infundibula. The CoW was found to be more often complete in women than in men (25.22% compared with 18.41%, &lt;i&gt;P&lt;/i&gt; = .024) and in African Caribbean (34.86%) compared with White European (19.19%) and South Asian (14.23%) subjects (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001 each).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Intracranial arterial stenoses were independently associated with ethnicity after adjusting for vascular risk factors, having the highest prevalence among South Asians. The prevalence of aneurysms was higher than that in previous population-based studies. We observed anatomic differences in the CoW configuration among women, men, and ethnicities.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="twitter:title" content="High-Resolution MRA Cerebrovascular Findings in a Tri-Ethnic Population" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Incidental findings on brain MRI and variations of the circle of Willis (CoW) are relatively common among the general population. Ethnic differences have been described before, but few studies have explored the prevalence of incidental intracranial cerebrovascular findings and CoW variants in the setting of a single multiethnic cohort. The purpose of this investigation was to describe both incidental cerebrovascular findings and the morphology of the CoW on high-resolution 3T TOF-MRA in a UK tri-ethnic population-based cohort and to present updated prevalence estimates and morphologic reference values.

MATERIALS AND METHODS: We studied participants from the UK Southall and Brent REvisited study who underwent 3T brain MRI between 2014 and 2018. TOF-MRA images were assessed for the presence of incidental cerebrovascular findings and used to determine CoW anatomy.

RESULTS: Seven hundred fifty participants (mean age, 71.28 [SD, 6.46] years; range, 46–90 years; 337 women), 322 White Europeans, 253 South Asians, and 175 African Caribbeans were included. Incidental cerebrovascular findings were observed in 84 subjects (11.2%, 95% CI, 9.0%–13.7%; 36 women; 42.86%, 95% CI, 32.11%–54.12%), with cerebral aneurysms being the most frequent followed by intracranial arterial stenoses with the highest prevalence among South Asians compared with White European (OR: 2.72; 95% CI, 1.22–6.08; P = .015) and African Caribbean subjects (OR: 2.79; 95% CI, 1.00–7.82; P = .051). Other findings included arteriovenous malformations and infundibula. The CoW was found to be more often complete in women than in men (25.22% compared with 18.41%, P = .024) and in African Caribbean (34.86%) compared with White European (19.19%) and South Asian (14.23%) subjects ( P &lt; .001 each).

CONCLUSIONS: Intracranial arterial stenoses were independently associated with ethnicity after adjusting for vascular risk factors, having the highest prevalence among South Asians. The prevalence of aneurysms was higher than that in previous population-based studies. We observed anatomic differences in the CoW configuration among women, men, and ethnicities.

ACA
:   anterior cerebral artery
AcomA
:   anterior comunicating artery
CoW
:   circle of Willis
CVM
:   cerebral vascular malformations
ICAS
:   intracranial arterial stenoses
PCA
:   posterior cerebral artery
PcomA
:   posterior communicating artery" />
<meta name="og-title" property="og:title" content="High-Resolution MRA Cerebrovascular Findings in a Tri-Ethnic Population" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/45/11/1661" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Incidental findings on brain MRI and variations of the circle of Willis (CoW) are relatively common among the general population. Ethnic differences have been described before, but few studies have explored the prevalence of incidental intracranial cerebrovascular findings and CoW variants in the setting of a single multiethnic cohort. The purpose of this investigation was to describe both incidental cerebrovascular findings and the morphology of the CoW on high-resolution 3T TOF-MRA in a UK tri-ethnic population-based cohort and to present updated prevalence estimates and morphologic reference values.

MATERIALS AND METHODS: We studied participants from the UK Southall and Brent REvisited study who underwent 3T brain MRI between 2014 and 2018. TOF-MRA images were assessed for the presence of incidental cerebrovascular findings and used to determine CoW anatomy.

RESULTS: Seven hundred fifty participants (mean age, 71.28 [SD, 6.46] years; range, 46–90 years; 337 women), 322 White Europeans, 253 South Asians, and 175 African Caribbeans were included. Incidental cerebrovascular findings were observed in 84 subjects (11.2%, 95% CI, 9.0%–13.7%; 36 women; 42.86%, 95% CI, 32.11%–54.12%), with cerebral aneurysms being the most frequent followed by intracranial arterial stenoses with the highest prevalence among South Asians compared with White European (OR: 2.72; 95% CI, 1.22–6.08; P = .015) and African Caribbean subjects (OR: 2.79; 95% CI, 1.00–7.82; P = .051). Other findings included arteriovenous malformations and infundibula. The CoW was found to be more often complete in women than in men (25.22% compared with 18.41%, P = .024) and in African Caribbean (34.86%) compared with White European (19.19%) and South Asian (14.23%) subjects ( P &lt; .001 each).

CONCLUSIONS: Intracranial arterial stenoses were independently associated with ethnicity after adjusting for vascular risk factors, having the highest prevalence among South Asians. The prevalence of aneurysms was higher than that in previous population-based studies. We observed anatomic differences in the CoW configuration among women, men, and ethnicities.

ACA
:   anterior cerebral artery
AcomA
:   anterior comunicating artery
CoW
:   circle of Willis
CVM
:   cerebral vascular malformations
ICAS
:   intracranial arterial stenoses
PCA
:   posterior cerebral artery
PcomA
:   posterior communicating artery" />
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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Neurovascular/Stroke Imaging</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">High-Resolution MRA Cerebrovascular Findings in a Tri-Ethnic Population</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Rafael Rehwald</span>, <span class="highwire-citation-author" data-delta="1">Carole H. Sudre</span>, <span class="highwire-citation-author" data-delta="2">Lorna Smith</span>, <span class="highwire-citation-author" data-delta="3">Magdalena Sokolska</span>, <span class="highwire-citation-author" data-delta="4">Therese Tillin</span>, <span class="highwire-citation-author" data-delta="5">David Atkinson</span>, <span class="highwire-citation-author" data-delta="6">Nishi Chaturvedi</span>, <span class="highwire-citation-author" data-delta="7">Alun D. Hughes</span> and <span class="highwire-citation-author" data-delta="8">Hans Rolf Jäger</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2024,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1661-1669; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8402 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-111448--6538804823" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Rafael Rehwald </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Neuroradiological Academic Unit (R.R., M.S., H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London London, UK</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Rafael%2BRehwald%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rehwald%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ARafael%2BRehwald%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-4357-3581" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Rafael Rehwald</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Carole H. Sudre </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>MRC Unit for Lifelong Health and Ageing at University college London (C.H.S., T.T., N.C., A.D.H.), Institute of Cardiovascular Science, University College London, London, UK</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Dementia Research Centre (C.H.S.), University College London Queen Square Institute of Neurology, University College London, London, UK</div><div class='author-affiliation'><span class='nlm-sup'>d</span>School of Biomedical Engineering (C.H.S.), King's College, London, UK</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Carole%2BH.%2BSudre%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sudre%20CH&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ACarole%2BH.%2BSudre%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5753-428X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Carole H. Sudre</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Lorna Smith </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Centre for Medical Imaging (L.S., D.A.), Division of Medicine, University College London, London, UK</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Lorna%2BSmith%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Smith%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ALorna%2BSmith%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1454-0732" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Lorna Smith</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Magdalena Sokolska </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Neuroradiological Academic Unit (R.R., M.S., H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London London, UK</div><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Medical Physics and Biomedical Engineering (M.S.), University College London Hospitals National Health Service (NHS) Foundation Trust, London, UK</div></span></div><ul class="author-tooltip-find-more"><li 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 45</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 11 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Nov 2024 </div></div>
      
      
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1661-1669; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8402 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Rafael</span> <span class="nlm-surname">Rehwald</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Carole H.</span> <span class="nlm-surname">Sudre</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Lorna</span> <span class="nlm-surname">Smith</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Magdalena</span> <span class="nlm-surname">Sokolska</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Therese</span> <span class="nlm-surname">Tillin</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">David</span> <span class="nlm-surname">Atkinson</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Nishi</span> <span class="nlm-surname">Chaturvedi</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Alun D.</span> <span class="nlm-surname">Hughes</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Hans Rolf</span> <span class="nlm-surname">Jäger</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1661-1669; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8402 </span></div>
  
  
  
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