Detailed 3D-morphometry of the anterior communicating artery: potential clinical and neurosurgical implications

Although a site common for pathology and of great importance to the neurosurgeon, the three-dimensional (3D) morphometry of the anterior communicating artery (ACoA) has had incomplete descriptions in the literature.

Using a novel 3D digital-image computer data analysis system, 115 patients underwent evaluation of their ACoA based on DICOM files derived from CT angiography. Measurements included the length, internal diameter, volume, deviation index (DI) and tortuosity index (TI).

Of 115 samples, 85 were visualized clearly enough for morphometric analysis. The mean internal diameter was 1.86 mm and this tended to be greater in males (P < 0.05). The mean length of the ACoA was 3.99 mm and the mean volume was 11.61 mm(3). The mean TI for the ACoA was 0.84 and the mean DI was 0.62 mm. A significant relationship between DI and length, DI and volume, and DI and TI were found. The significant correlation of diameter to volume, and length related to volume, DI and TI, as well as TI related to length, volume and DI were noticed. There were no relationship between any parameter and age.

A detailed knowledge of the 3D-morphometry of the ACoA demonstrates that in almost 50% of individuals the ACoA is straight in their course. Detailed data regarding arterial topography and trajectory as found in our study may be also of use in detecting early changes in this vessel due to pathology and may assist in the treatment of vascular lesions and planning of neurosurgical or interventional radiological procedures in the region including ACoA aneurysms.