Radiology Department, Zhejiang Hospital, Hangzhou, 310030, China.
Neurology Department, Zhejiang Hospital, Hangzhou, 310030, China.
BMC Neurol. 2024 Aug 10;24(1):279. doi: 10.1186/s12883-024-03788-9.
Calcification is common in advanced atheromatous plaque, but its clinical significance remains unclear. This study aimed to assess the prevalence of plaque calcification in the moderate-to-severe internal carotid artery stenosis and investigate its relationship with ipsilateral ischemia.
The retrospective study included 178 patients detected with proximal internal carotid artery (pICA) stenosis of ≥ 50% on multidetector computed tomography at Zhejiang Hospital from January 2019 to March 2023. Association between plaque calcification characteristics (calcification thickness, position, type, circumferential extent, calcium volume and calcium score) and ipsilateral cerebrovascular events was analyzed.
The 178 patients (mean age 71.24 ± 10.02 years, 79.78% males) had 224 stenosed pICAs overall. Plaque calcification was noted in 200/224 (89.29%) arteries. Calcification rates were higher in older age-groups. Calcification volume (r = 0.219, p < 0.001) and calcification score (r = 0.230, p < 0.001) were correlated with age. Ipsilateral ischemic events were significantly more common in the noncalcification group than in the calcification group (χ = 4.160, p = 0.041). The most common calcification type was positive rim sign calcification (87/200, 43.50%), followed by bulky calcification (66/200, 33.00%); both were significantly associated with ischemic events (χ = 10.448, p = 0.001 and χ = 4.552, p = 0.033, respectively). Calcification position, thickness, and circumferential extent, and calcification volume and score, were not associated with ischemic events. In multivariate analysis, positive rim signs (OR = 2.795, 95%CI 1.182-6.608, p = 0.019) was an independent predictor of ischemic events.
Plaque calcification in proximal internal carotid artery is common, and prevalence increases with age. Calcification characteristics could be predictive of ipsilateral ischemic events. The positive rim sign within plaque is a high-risk factor for a future ischemic event.
钙化在动脉粥样硬化斑块中很常见，但它的临床意义尚不清楚。本研究旨在评估中重度颈内动脉狭窄患者斑块钙化的发生率，并探讨其与同侧缺血的关系。
本回顾性研究纳入了 2019 年 1 月至 2023 年 3 月在浙江大学医院接受多排螺旋 CT 检测近端颈内动脉（pICA）狭窄程度≥50%的 178 例患者。分析斑块钙化特征（钙化厚度、位置、类型、周向范围、钙体积和钙评分）与同侧脑血管事件之间的关系。
178 例患者（平均年龄 71.24±10.02 岁，79.78%为男性）共 224 条狭窄 pICA。224 条动脉中 200 条（89.29%）有斑块钙化。年龄较大的患者钙化率更高。钙化体积（r=0.219，p<0.001）和钙化评分（r=0.230，p<0.001）与年龄呈正相关。无钙化组同侧缺血性事件明显多于钙化组（χ²=4.160，p=0.041）。最常见的钙化类型是阳性边缘征钙化（87/200，43.50%），其次是块状钙化（66/200，33.00%）；两种类型均与缺血性事件显著相关（χ²=10.448，p=0.001 和 χ²=4.552，p=0.033）。钙化位置、厚度、周向范围、钙体积和钙评分与缺血性事件无关。多因素分析显示，阳性边缘征（OR=2.795，95%CI 1.182-6.608，p=0.019）是同侧缺血性事件的独立预测因子。
近端颈内动脉斑块钙化很常见，且随着年龄的增长而增加。钙化特征可能预测同侧缺血性事件。斑块内的阳性边缘征是未来发生缺血性事件的高危因素。
