TY - JOUR
T1 - Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall Imaging
AU - Yang, Wen Jie
AU - Wasserman, Bruce A.
AU - Zheng, Lu
AU - Huang, Zhong Qing
AU - Li, Jia
AU - Abrigo, Jill
AU - Wong, Simon Sin man
AU - Ying, Michael Tin cheung
AU - Chu, Winnie Chiu Wing
AU - Wong, Lawrence Ka sing
AU - Leung, Thomas Wai Hong
AU - Chen, Xiang Yan
N1 - Funding Information:
We would like to give special thanks to Dr. Li Liu, Department of Radiology and Radiological Sciences, the Johns Hopkins Hospital, for her assistance in statistical analyses. Funding. This study has received funding by grants from the General Research Fund from Research Grants Council of Hong Kong (GRF, Project No. 14112916) and the Health and Medical Research Fund of Hong Kong (HMRF, Project No. 04152586).
Funding Information:
This study has received funding by grants from the General Research Fund from Research Grants Council of Hong Kong (GRF, Project No. 14112916) and the Health and Medical Research Fund of Hong Kong (HMRF, Project No. 04152586).
Publisher Copyright:
© Copyright © 2021 Yang, Wasserman, Zheng, Huang, Li, Abrigo, Wong, Ying, Chu, Wong, Leung and Chen.
PY - 2021/7/15
Y1 - 2021/7/15
N2 - Background and Purpose: Intracranial arterial calcification (IAC) has been the focus of much attention by clinicians and researchers as an indicator of intracranial atherosclerosis, but correlations of IAC patterns (intimal or medial) with the presence of atherosclerotic plaques and plaque stability are still a matter of debate. Our study aimed to assess the associations of IAC patterns identified on computed tomography (CT) with the presence of plaque detected on vessel wall magnetic resonance imaging and plaque stability. Materials and Methods: Patients with stroke or transient ischemic attack and intracranial artery stenosis were recruited. IAC was detected and localized (intima or media) on non-contrast CT images. Intracranial atherosclerotic plaques were identified using vessel wall magnetic resonance imaging and matched to corresponding CT images. Associations between IAC patterns and culprit atherosclerotic plaques were assessed by using multivariate regression. Results: Seventy-five patients (mean age, 63.4 ± 11.6 years; males, 46) were included. Two hundred and twenty-one segments with IAC were identified on CT in 66 patients, including 86 (38.9%) predominantly intimal calcifications and 135 (61.1%) predominantly medial calcifications. A total of 72.0% of intimal calcifications coexisted with atherosclerotic plaques, whereas only 10.2% of medial calcifications coexisted with plaques. Intimal calcification was more commonly shown in non-culprit plaques than culprit plaques (25.9 vs. 9.4%, P = 0.008). The multivariate mixed logistic regression adjusted for the degree of stenosis showed that intimal calcification was significantly associated with non-culprit plaques (OR, 2.971; 95% CI, 1.036–8.517; P = 0.043). Conclusion: Our findings suggest that intimal calcification may indicate the existence of a stable form of atherosclerotic plaque, but plaques can exist in the absence of intimal calcification especially in the middle cerebral artery.
AB - Background and Purpose: Intracranial arterial calcification (IAC) has been the focus of much attention by clinicians and researchers as an indicator of intracranial atherosclerosis, but correlations of IAC patterns (intimal or medial) with the presence of atherosclerotic plaques and plaque stability are still a matter of debate. Our study aimed to assess the associations of IAC patterns identified on computed tomography (CT) with the presence of plaque detected on vessel wall magnetic resonance imaging and plaque stability. Materials and Methods: Patients with stroke or transient ischemic attack and intracranial artery stenosis were recruited. IAC was detected and localized (intima or media) on non-contrast CT images. Intracranial atherosclerotic plaques were identified using vessel wall magnetic resonance imaging and matched to corresponding CT images. Associations between IAC patterns and culprit atherosclerotic plaques were assessed by using multivariate regression. Results: Seventy-five patients (mean age, 63.4 ± 11.6 years; males, 46) were included. Two hundred and twenty-one segments with IAC were identified on CT in 66 patients, including 86 (38.9%) predominantly intimal calcifications and 135 (61.1%) predominantly medial calcifications. A total of 72.0% of intimal calcifications coexisted with atherosclerotic plaques, whereas only 10.2% of medial calcifications coexisted with plaques. Intimal calcification was more commonly shown in non-culprit plaques than culprit plaques (25.9 vs. 9.4%, P = 0.008). The multivariate mixed logistic regression adjusted for the degree of stenosis showed that intimal calcification was significantly associated with non-culprit plaques (OR, 2.971; 95% CI, 1.036–8.517; P = 0.043). Conclusion: Our findings suggest that intimal calcification may indicate the existence of a stable form of atherosclerotic plaque, but plaques can exist in the absence of intimal calcification especially in the middle cerebral artery.
KW - atherosclerosis
KW - calcification
KW - computed tomography
KW - intracranial disease
KW - magnetic resonance imaging
UR - http://www.scopus.com/inward/record.url?scp=85111584295&partnerID=8YFLogxK
U2 - 10.3389/fneur.2021.619233
DO - 10.3389/fneur.2021.619233
M3 - Journal article
AN - SCOPUS:85111584295
SN - 1664-2295
VL - 12
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 619233
ER -