Quiney Brendan, Ying Stephen M, Hippe Daniel S, Balu Niranjan, Urdaneta-Moncada Alfonso R, Mossa-Basha Mahmud
From the *Department of Radiology, University of British Columbia, Vancouver, British Columbia; †Department of Radiology, University of Manitoba, Winnipeg, Manitoba, Canada; and ‡Department of Radiology, University of Washington, Seattle, WA.
J Comput Assist Tomogr. 2017 Nov/Dec;41(6):849-853. doi: 10.1097/RCT.0000000000000629.
The aim of this article was to evaluate the association of intracranial artery calcification (IAC) with acute downstream ischemic stroke (dAIS)/transient ischemic attack while considering stenosis.
Consecutive stroke computed tomography angiography head/neck examinations from January 2010 to April 2010 were reviewed. Per-vessel IAC and stenosis of greater than or equal to 30% were documented by 2 neuroradiologists. Associations between calcification and dAIS were assessed using multivariate logistic regression, controlling for traditional risk factors and stenosis.
A total of 1287 arterial segments from 99 patients were reviewed. Intracranial artery calcification was significantly associated with dAIS (odds ratio [OR], 2.2; P = 0.009). This association persisted among nonstenotic arteries, with significantly higher likelihood of dAIS for arteries with IAC than those without (OR, 2.5; P = 0.009). However, among stenotic arteries, calcified stenoses had a lower association of dAIS than noncalcified stenoses (OR, 0.55; 95% confidence interval, 0.17-1.8; P = 0.33).
Without concurrent stenosis, IAC is a significant risk factor for dAIS. When stenosis is present, IAC does not increase the association with dAIS. Stenotic and nonstenotic calcifications may represent different disease processes, as represented in the histology literature.
本文旨在评估颅内动脉钙化（IAC）与急性下游缺血性卒中（dAIS）/短暂性脑缺血发作之间的关联，并考虑狭窄因素。
回顾了2010年1月至2010年4月连续进行的卒中计算机断层扫描血管造影头部/颈部检查。两名神经放射科医生记录每条血管的IAC和大于或等于30%的狭窄情况。使用多因素逻辑回归评估钙化与dAIS之间的关联，同时控制传统危险因素和狭窄情况。
共对99例患者的1287个动脉节段进行了评估。颅内动脉钙化与dAIS显著相关（比值比[OR]为2.2；P = 0.009）。这种关联在无狭窄的动脉中持续存在，有IAC的动脉发生dAIS的可能性显著高于无IAC的动脉（OR为2.5；P = 0.009）。然而，在有狭窄的动脉中，钙化狭窄与dAIS的关联低于非钙化狭窄（OR为0.55；95%置信区间为0.17 - 1.8；P = 0.33）。
在无并发狭窄的情况下，IAC是dAIS的一个重要危险因素。当存在狭窄时，IAC不会增加与dAIS的关联。狭窄性钙化和非狭窄性钙化可能代表不同的疾病过程，正如组织学文献中所描述的那样。
