Zheng Chong, Yan Shaozhen, Fu Fan, Zhao Cheng, Guo Daode, Wang Zhichao, Lu Jie
Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
Front Neurol. 2021 May 13;12:659156. doi: 10.3389/fneur.2021.659156. eCollection 2021.
To investigate the characteristics of cervicocephalic spotty calcium (SC) and coronary atherosclerosis in patients with acute ischemic stroke (AIS) and to assess the predictive value of SC for coronary atherosclerosis using combined coronary and cervicocephalic CTA. Patients with AIS ( = 70) confirmed by brain MRI or CT and patients with asymptomatic carotid atherosclerosis ( = 58) confirmed by carotid ultrasonography were enrolled in our study. Subjects in both groups underwent combined coronary and cervicocephalic CTA. SC was used to evaluate cervicocephalic atherosclerosis. Coronary artery stenosis (CAS) ≥ 50% by segment and coronary artery calcium score (CACS) were used to evaluate coronary atherosclerosis. The SC frequency and the difference in coronary atherosclerosis between the two groups were compared, and the correlation between SC and coronary atherosclerosis was analyzed. Independent factors for CAS ≥ 50% were assessed via logistic regression analysis. Receiver operating characteristic curve analysis was performed to evaluate the added value of SC for predicting CAS ≥ 50%. Both SC and the CACS were significantly higher in the Stroke group than in the Control group (total SC count: 6.83 ± 4.34 vs. 2.98 ± 2.87, < 0.05; CACS: 477.04 ± 798.01 vs. 136.31 ± 205.65, < 0.05). There were significant differences in the presence of CAS ≥ 50% (61.4 vs. 27.6%, < 0.001). SC and coronary atherosclerosis were significantly correlated for both the CACS and CAS ≥ 50% ( = 0.746 and 0.715, respectively; < 0.001). SC was an independent predictor for CAS ≥ 50%. SC correlates significantly with the CACS and could serve as an independent predictor of CAS ≥ 50% in patients with AIS, which suggests that combined cerebrovascular and cardiovascular assessments are of importance for such patients.
研究急性缺血性卒中（AIS）患者的颈脑斑点状钙化（SC）及冠状动脉粥样硬化特征，并使用冠状动脉和颈脑联合CT血管造影（CTA）评估SC对冠状动脉粥样硬化的预测价值。纳入经脑磁共振成像（MRI）或计算机断层扫描（CT）确诊的AIS患者（n = 70）以及经颈动脉超声确诊的无症状颈动脉粥样硬化患者（n = 58）。两组受试者均接受冠状动脉和颈脑联合CTA检查。使用SC评估颈脑动脉粥样硬化。采用节段性冠状动脉狭窄（CAS）≥50%及冠状动脉钙化积分（CACS）评估冠状动脉粥样硬化。比较两组的SC频率及冠状动脉粥样硬化差异，并分析SC与冠状动脉粥样硬化的相关性。通过逻辑回归分析评估CAS≥50%的独立因素。绘制受试者工作特征曲线分析以评估SC对预测CAS≥50%的增加值。卒中组的SC及CACS均显著高于对照组（总SC计数：6.83±4.34对2.98±2.87，P<0.05；CACS：477.04±798.01对136.31±205.65，P<0.05）。CAS≥50%的发生率存在显著差异（61.4%对27.6%，P<0.001）。SC与CACS及CAS≥50%的冠状动脉粥样硬化均显著相关（分别为r = 0.746和0.715；P<0.001）。SC是CAS≥50%的独立预测因子。SC与CACS显著相关，可作为AIS患者CAS≥50%的独立预测因子，这表明脑血管和心血管联合评估对此类患者具有重要意义。
