To propose and validate a revised imaging-based classification (MCA-EB) of early branches of the MCA using computed tomographic angiography (CTA).
Approach:
Study Design: Retrospective study involving 200 adult patients who underwent CTA between 2020–2024, excluding those with specific intracranial conditions.
Morphometric Analysis: Morphometric measurements of MCA early branches (EBs) were performed using dedicated software, assessing presence, type, and dimensions.
Statistical Methods: Statistical analyses included Kendall’s tau-b, Spearman correlation, and Cohen’s kappa for reproducibility analysis.
Key Findings:
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 τ = −0.009, p = 0.86; EFB1 τ = −0.148, p = 0.09).
The MCA-EB classification comprises four types, from absence of EBs (Type I, 46.3%) to combined ETB and EFB variants (Type IV, 9%).
Interpretation:
The MCA-EB classification provides a simplified and standardized approach to categorizing MCA early branches.
Limitations:
Exclusion of patients with certain intracranial conditions may limit generalizability.
Retrospective nature may introduce selection bias.
Conclusion:
The MCA-EB classification system may support future research on the clinical relevance of MCA early branches.
by Arkadiusz Kacała, Małgorzata Milnerowicz-Bescond, Maciej Ziomek, Marek Łukasiewicz, Łukasz Noszczak, Weronika Wrona, Wiktoria Wdowiak, Mateusz Dorochowicz, Kamil Litwinowicz, Anna Zimny, Maciej Guziński
