Serghine Yassine, Laurent-Chabalier Sabine, Thouvenot Eric, Parvu Teodora, Renard Dimitri
Department of Neurology, CHU Nîmes, Hôpital Carémeau, Univ. Montpellier, Rue du Pr Debré, Nîmes, 30900, France.
Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, CHU Nîmes, Univ. Montpellier, Nîmes, France.
Acta Neurol Belg. 2025 Apr;125(2):463-468. doi: 10.1007/s13760-025-02719-w. Epub 2025 Jan 15.
Radiological calcified cerebral embolism (CCE) characteristics have been reported in small case series. Our aim was to describe clinical and radiological CCE characteristics in a large number of CCE and to compare characteristics between different patient groups.
Characteristics of 79 stroke patients with CCE were analyzed retrospectively. Clinical characteristics included demographics, cardiovascular risk factors, stroke history, history of surgical/endovascular cardiovascular intervention, NIHSS on admission, stroke etiology, and presumed CCE source. Radiological characteristics included CCE diameter, density, number, involved cerebral artery and segment, and CCE distribution.
A total of 242 CCE were analyzed in 79 patients (median age 79, 56% men). Presumed CCE source was vascular in 54%, mixed vascular/cardiac in 32%, and undetermined in 14%. Median CCE diameter was 1.55 mm and median density 146HU. Multiple CCE were observed in 34% of patients. The middle cerebral artery was the most frequently (84%) involved artery. CCE predominantly involved distal segments. Single uniterritorial, multiple uniterritorial, and multiterritorial CCE were observed in 63%, 22%, and 15% of patients respectively. Patients with combined vascular/cardiac CCE source were older compared with patients with vascular CCE source (p = 0.0135). Correlation coefficient between CCE diameter and density was 0.69. Clinical characteristics were similar between the groups with single uniterritorial, multiple uniterritorial, and multiterritorial CCE, apart from diabetes (p = 0.0076). Concerning radiological characteristics, median diameter and density differed between these three groups (p = 0.0029 and p = 0.0035, respectively). CCE diameter was larger (p < 0.0001) and density higher (p < 0.0001) when CCE involved proximal arterial segments.
Clinical and radiological characteristics of CCE patients and CCE are variable. CCE diameter and density and presence of diabetes history differed between CCE patients with single uniterritorial, multiple uniterritorial, and multiterritorial CCE.
小病例系列报道过放射性钙化性脑栓塞（CCE）的特征。我们的目的是描述大量CCE患者的临床和影像学CCE特征，并比较不同患者组之间的特征。
回顾性分析79例CCE卒中患者的特征。临床特征包括人口统计学、心血管危险因素、卒中病史、外科/血管内心血管介入史、入院时美国国立卫生研究院卒中量表（NIHSS）评分、卒中病因以及推测的CCE来源。影像学特征包括CCE直径、密度、数量、受累脑动脉及节段，以及CCE分布。
共分析了79例患者的242个CCE（中位年龄79岁，男性占56%）。推测CCE来源为血管性的占54%，血管/心脏混合性的占32%，不明的占14%。CCE中位直径为1.55毫米，中位密度为146亨氏单位（HU）。34%的患者观察到多个CCE。大脑中动脉是最常受累的动脉（84%）。CCE主要累及远端节段。分别在63%、22%和15%的患者中观察到单区域、多区域和跨区域CCE。血管/心脏混合性CCE来源的患者比血管性CCE来源的患者年龄更大（p = 0.0135）。CCE直径与密度的相关系数为0.69。单区域、多区域和跨区域CCE组之间的临床特征相似，但糖尿病情况除外（p = 0.0076）。关于影像学特征，这三组之间的中位直径和密度不同（分别为p = 0.0029和p = 0.0035）。当CCE累及近端动脉节段时，CCE直径更大（p < 0.0001）且密度更高（p < 0.0001）。
CCE患者及CCE的临床和影像学特征各不相同。单区域、多区域和跨区域CCE的CCE患者之间，CCE直径、密度及糖尿病病史存在差异。
