Middle cerebral artery variations detected by magnetic resonance angiography

Middle cerebral artery (MCA) variations are found incidentally on cranial magnetic resonance angiography (MRA). Our goal was to examine the incidence and types of MCA variations detected by MRA. Between April 1996 and March 1999, cranial MRA was performed in 432 cases at our institution. Most of the patients examined had or were suspected to have cerebrovascular disease. After excluding 7 patients with moyamoya disease, we retrospectively reviewed 425 MRA results. A 1.5-T scanner was used in all studies, and maximum-intensity projection images obtained using the three-dimensional time-of-flight technique were displayed stereoscopically. In the 425 patients MRA revealed 16 anomalous MCAs, including 9 duplicated MCAs, 5 accessory MCAs, and 2 fenestrated MCAs, which is a rate of 3.8%. Thus, although the clinical significance is not great, we found a relatively high incidence of anomalous MCAs on MRA. We stress that knowledge and recognition of these variations are useful and important during the interpretation of cranial MRA.