Shiraishi Makoto, Hasegawa Yasuhiro, Narita Nobuyoshi, Miyake Hitoshi
Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
J Stroke Cerebrovasc Dis. 2019 Sep;28(9):2429-2433. doi: 10.1016/j.jstrokecerebrovasdis.2019.06.029. Epub 2019 Jul 9.
Intracranial arteriosclerotic disease (ICAD) is common in Asians and has been presumed to be largely associated with metabolic syndrome (MetS), but the risks for asymptomatic ICAD detectable in examinations of the brain, among other tests, are not well known. The present study is aimed at identifying the risks for asymptomatic ICAD using data on risk factors obtained in health checkups, including data from magnetic resonance imaging (MRI), chest computed tomography (CT), and neck echography.
Subjects comprised 103 examinees more than equal to 40 years old (56.9 ± 4.7 years, 93 men) who underwent head MRI, chest CT, and carotid echography in the same period in a workplace health checkup between April and September 2014. Subjects were evaluated for ICAD based on stenosis of bilateral middle cerebral arteries and the basilar artery on previously reported scores from magnetic resonance angiography. Evaluations for extracranial arteriosclerotic disease (ECAD) were based on findings from carotid echography, and total calcium scores were calculated based on the number, areas, and peak Hounsfield computed tomographic numbers of the aortic arch calcified lesion detected.
ICAD, including mild cases with stenosis less than 50%, was seen in 21 subjects (20.3%); and MetS was evident in 12 subjects (11.7%). Logistic regression analysis with multivariate adjustment for major vascular risk factor demonstrated that echogenic of plaque was significantly associated with the ICAD (OR 3.69, 95%CI 1.02-13.3), however age was significant predictor of the risk profile in patients with ECAD.
Carotid atherosclerosis could predict intracranial atherosclerosis in middle-aged people. However, further study with large sample size is warranted.
颅内动脉粥样硬化疾病（ICAD）在亚洲人中很常见，并且一直被认为在很大程度上与代谢综合征（MetS）相关，但在脑部检查及其他检查中可检测到的无症状ICAD的风险尚不清楚。本研究旨在利用健康体检中获得的危险因素数据，包括来自磁共振成像（MRI）、胸部计算机断层扫描（CT）和颈部超声检查的数据，来确定无症状ICAD的风险。
研究对象包括103名年龄在40岁及以上的受检者（年龄56.9±4.7岁，男性93名），他们在2014年4月至9月期间的一次职场健康体检中同期接受了头部MRI、胸部CT和颈动脉超声检查。根据先前报道的磁共振血管造影评分，基于双侧大脑中动脉和基底动脉的狭窄情况对研究对象进行ICAD评估。颅外动脉粥样硬化疾病（ECAD）的评估基于颈动脉超声检查结果，并根据检测到的主动脉弓钙化病变的数量、面积和峰值亨氏单位计算机断层扫描数值计算总钙评分。
21名研究对象（20.3%）出现ICAD，包括狭窄程度小于50%的轻度病例；12名研究对象（11.7%）存在明显的MetS。对主要血管危险因素进行多变量调整的逻辑回归分析表明，斑块的回声与ICAD显著相关（比值比3.69，95%置信区间1.02-13.3），然而年龄是ECAD患者风险状况的重要预测因素。
颈动脉粥样硬化可预测中年人的颅内粥样硬化。然而，有必要进行更大样本量的进一步研究。
