The middle cerebral artery early branches classification (MCA-EB): a novel imaging-based approach

Area of Science:

• Neurology
• Radiology
• Anatomy

Background:

• The middle cerebral artery (MCA) is a critical cerebral vessel.
• Existing classifications of MCA early branches (EBs) lack comprehensive data and anatomic variant representation.

Purpose of the Study:

• To develop and validate a novel imaging-based classification (MCA-EB) for MCA early branches (EBs).
• Utilize computed tomographic angiography (CTA) for classification refinement.

Main Methods:

• Retrospective analysis of 200 adult patients undergoing CTA.
• Exclusion of patients with intracranial arterial lesions or poor contrast.
• Morphometric analysis of MCA EBs, including early temporal (ETB) and frontal branches (EFB).
• Development of the MCA-EB classification based on EB number and distribution.
• Statistical analysis including correlation and reproducibility assessments.

Main Results:

• 271 EBs identified in 215 MCAs (53.25%).
• Early temporal branches (ETBs) were more prevalent (72.7%) than early frontal branches (EFBs) (27.3%).
• The MCA-EB classification included four types, with Type I (absence of EBs) at 46.3% and Type IV (combined ETB and EFB variants) at 9%.

Conclusions:

• The MCA-EB classification offers a simplified and standardized approach to MCA EBs.
• This system is valuable for surgical planning and identifying anatomical variants.
• Facilitates future research into the clinical significance of MCA EBs.