Anwar Zeeshan, Zan Elcin, Carone Marco, Ozturk Arzu, Sozio Stephen M, Yousem David M
Aga Khan University School of Medicine, Karachi, Pakistan.
Indian J Radiol Imaging. 2011 Jul;21(3):215-20. doi: 10.4103/0971-3026.85371.
Extracranial superficial temporal artery (STA) calcification is an unusual finding seen in patients with chronic kidney disease and has unknown ramifications with respect to intracranial ischemic disease. We sought to determine the association between the risk factors for vascular calcification and this rare phenomenon, in patients with chronic renal failure, and to assess the coexistence of cerebral ischemia.
Medical records and laboratory data on risk factors for vascular calcification were retrospectively retrieved for 453 patients with a discharge diagnosis of end-stage renal disease (ESRD). CT head examinations were reviewed to identify and associate STA calcification with 1) risk factors for the vascular calcification, 2) intracranial artery calcification, and 3) cerebral ischemia (white matter and/or cortical ischemic changes).
STA calcification was present in 9.9% (45/453) of the studied cohort. The prevalence of cerebral ischemia was 24.4% (11/45) in patients with STA calcification and 9.3% (38/408) in patients without it. Diabetes mellitus (OR: 2.56, 95% CI: 1.059-6.208; P=0.037) was independently associated with the risk of STA calcification. The risk of cerebral ischemia, however, was not related to STA calcification (P=0.221).
The presence of diabetes mellitus is important in describing the risk of STA calcification in patients with ESRD, whereas age, gender, hypertension, serum calcium, serum phosphate, or serum hemoglobin levels are not. The risk of cerebral ischemia is not related to STA calcification but has the strongest association with diabetes mellitus.
颅外颞浅动脉(STA)钙化是慢性肾病患者中一种不常见的表现,其对颅内缺血性疾病的影响尚不清楚。我们试图确定慢性肾衰竭患者血管钙化风险因素与这种罕见现象之间的关联,并评估脑缺血的共存情况。
回顾性检索453例出院诊断为终末期肾病(ESRD)患者的血管钙化风险因素的病历和实验室数据。对头颅CT检查进行评估,以确定STA钙化与以下因素的关联:1)血管钙化的风险因素;2)颅内动脉钙化;3)脑缺血(白质和/或皮质缺血改变)。
在所研究的队列中,9.9%(45/453)的患者存在STA钙化。STA钙化患者的脑缺血患病率为24.4%(11/45),无STA钙化患者的脑缺血患病率为9.3%(38/408)。糖尿病(OR:2.56,95%CI:1.059 - 6.208;P = 0.037)与STA钙化风险独立相关。然而,脑缺血风险与STA钙化无关(P = 0.221)。
糖尿病的存在对于描述ESRD患者STA钙化风险很重要,而年龄、性别、高血压、血清钙、血清磷或血清血红蛋白水平则不然。脑缺血风险与STA钙化无关,但与糖尿病的关联最为密切。