Chiewvit Pipat, Tritrakam Siri-On, Kraumak Temporn
J Med Assoc Thai. 2015 Apr;98(4):414-22.
Our objective was to determine the distribution of intracranial atherosclerotic calcification, its association with risk factors, and cerebrovascular events in patients with major ischemic stroke.
In this retrospective study, 327 patients who underwent CT scan of brain were included and the clinical parameters were recorded. Two neuroradiologists evaluated the non-contrast axial CT images for any of intracranial arteries, based on a standard CT scoring system for extent (0-4) and thickness (0-4). The composite CT score for extent and thickness of these vascular segments or vessels were recorded on all patients.
Based on of MDCT features, 155 major ischemic stroke and 172 non-ischemic stroke were enrolled The highest prevalence of calcification was seen in intracranial internal carotid artery (IICA) (73%), and less commonly in the vertebral artery (8%). There were higher prevalence of intracranial artery calcification in ischemic stroke patients than non-ischemic stroke patients (82% vs. 52%, p < 0.0001). Hypertension (OR = 1.903, 95% CI: 1.019-3.552, p < 0.05), intracranial artery calcification (OR = 2.147, 95% CI: 1.143-4.033, p < 0.05), moderate degree of calcification (OR = 2.631, 95% CI: 1.299-5.260, p < 0.05), and severe degree of calcification (OR = 3.479, 95% CI: 1.500-8.068, p < 0.05) were found to be independently associated with ischemic stroke.
Significant intracranial atherosclerosis as determined by severe CT calcification had higher incidence in ischemic stroke patients. Intracranial artery calcification with moderate and severe degree of calcification and hypertension were independently significant associated with ischemic stroke. CT calcification score might serve as an indicator of intracranial atherosclerotic disease and might be useful in predicting ischemic stroke.
我们的目的是确定颅内动脉粥样硬化钙化的分布情况、其与危险因素的关联以及在主要缺血性卒中患者中的脑血管事件。
在这项回顾性研究中，纳入了327例行脑部CT扫描的患者，并记录临床参数。两名神经放射科医生根据标准CT评分系统，对颅内动脉的非增强轴位CT图像进行评估，评估范围（0 - 4）和厚度（0 - 4）。记录所有患者这些血管段或血管的范围和厚度的综合CT评分。
基于MDCT特征，纳入了155例主要缺血性卒中和172例非缺血性卒中患者。钙化发生率最高的是颅内颈内动脉（IICA）（73%），椎动脉较少见（8%）。缺血性卒中患者颅内动脉钙化的患病率高于非缺血性卒中患者（82%对52%，p < 0.0001）。高血压（OR = 1.�03，95%CI：1.019 - 3.552，p < 0.05）、颅内动脉钙化（OR = 2.147，95%CI：1.143 - 4.033，p < 0.05）、中度钙化（OR = 2.631，95%CI：1.299 - 5.260，p < 0.05）和重度钙化（OR = 3.479，95%CI：1.500 - 8.068，p < 0.05）被发现与缺血性卒中独立相关。
由严重CT钙化确定的显著颅内动脉粥样硬化在缺血性卒中患者中的发生率更高。中度和重度钙化的颅内动脉钙化以及高血压与缺血性卒中独立显著相关。CT钙化评分可能作为颅内动脉粥样硬化疾病的一个指标，可能有助于预测缺血性卒中。
