ArticleFrontiers in neurology
The middle cerebral artery early branches classification (MCA-EB): a novel imaging-based approach.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The middle cerebral artery (MCA) is one of the most clinically relevant cerebral vessels. Although early branches (EBs) of the MCA have been described, existing classifications are limited by small sample sizes and incomplete representation of anatomic variants. Purpose: To propose and validate a revised imaging-based classification (MCA-EB) of early branches of the MCA using computed tomographic angiography (CTA). Materials and Methods: This retrospective study included 200 adult patients who underwent computed tomographic angiography (CTA) between 2020-2024. Patients with intracranial arterial lesions, stenosis, mass effect, or poor contrast opacification were excluded. Morphometric measurements of MCA EBs were performed with dedicated software. Presence, type, and dimensions of early temporal (ETB) and frontal branches (EFB) were assessed. A revised classification system (MCA-EB) was developed based on EB number and distribution. Statistical analyses included Kendall's tau-b, Spearman correlation, and Cohen's kappa for reproducibility analysis. Results: A total of 271 EBs were identified in 215 MCAs (53.25%). ETBs were more frequent (197/271, 72.7%) than EFBs (74/271, 27.3%). Mean diameter was 0.86 mm for ETBs and 0.83 mm for EFBs. No significant correlation was found between EB diameter and distance from MCA origin (ETB1 Conclusion: MCA-EB provides a simplified and standardized classification of MCA early branches. This system may aid in surgical planning, improve recognition of anatomic variants, and support future research on the clinical relevance of MCA EBs.
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