Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall Imaging
Background and Purpose: Intracranial arterial calcification (IAC) has been the focus of much attention by clinicians and researchers as an indicator of intracranial atherosclerosis, but correlations of IAC patterns (intimal or medial) with the presence of atherosclerotic plaques and plaque stability...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.619233/full |
| _version_ | 1818886059912593408 |
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| author | Wen-Jie Yang Bruce A. Wasserman Lu Zheng Zhong-Qing Huang Zhong-Qing Huang Jia Li Jill Abrigo Simon Sin-man Wong Michael Tin-cheung Ying Winnie Chiu-Wing Chu Lawrence Ka-sing Wong Thomas Wai-Hong Leung Xiang-Yan Chen |
| author_facet | Wen-Jie Yang Bruce A. Wasserman Lu Zheng Zhong-Qing Huang Zhong-Qing Huang Jia Li Jill Abrigo Simon Sin-man Wong Michael Tin-cheung Ying Winnie Chiu-Wing Chu Lawrence Ka-sing Wong Thomas Wai-Hong Leung Xiang-Yan Chen |
| author_sort | Wen-Jie Yang |
| collection | DOAJ |
| description | Background and Purpose: Intracranial arterial calcification (IAC) has been the focus of much attention by clinicians and researchers as an indicator of intracranial atherosclerosis, but correlations of IAC patterns (intimal or medial) with the presence of atherosclerotic plaques and plaque stability are still a matter of debate. Our study aimed to assess the associations of IAC patterns identified on computed tomography (CT) with the presence of plaque detected on vessel wall magnetic resonance imaging and plaque stability.Materials and Methods: Patients with stroke or transient ischemic attack and intracranial artery stenosis were recruited. IAC was detected and localized (intima or media) on non-contrast CT images. Intracranial atherosclerotic plaques were identified using vessel wall magnetic resonance imaging and matched to corresponding CT images. Associations between IAC patterns and culprit atherosclerotic plaques were assessed by using multivariate regression.Results: Seventy-five patients (mean age, 63.4 ± 11.6 years; males, 46) were included. Two hundred and twenty-one segments with IAC were identified on CT in 66 patients, including 86 (38.9%) predominantly intimal calcifications and 135 (61.1%) predominantly medial calcifications. A total of 72.0% of intimal calcifications coexisted with atherosclerotic plaques, whereas only 10.2% of medial calcifications coexisted with plaques. Intimal calcification was more commonly shown in non-culprit plaques than culprit plaques (25.9 vs. 9.4%, P = 0.008). The multivariate mixed logistic regression adjusted for the degree of stenosis showed that intimal calcification was significantly associated with non-culprit plaques (OR, 2.971; 95% CI, 1.036–8.517; P = 0.043).Conclusion: Our findings suggest that intimal calcification may indicate the existence of a stable form of atherosclerotic plaque, but plaques can exist in the absence of intimal calcification especially in the middle cerebral artery. |
| first_indexed | 2024-12-19T16:15:19Z |
| format | Article |
| id | doaj.art-38efd410bc114065b6e3e08a1032b070 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-19T16:15:19Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-38efd410bc114065b6e3e08a1032b0702022-12-21T20:14:38ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-07-011210.3389/fneur.2021.619233619233Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall ImagingWen-Jie Yang0Bruce A. Wasserman1Lu Zheng2Zhong-Qing Huang3Zhong-Qing Huang4Jia Li5Jill Abrigo6Simon Sin-man Wong7Michael Tin-cheung Ying8Winnie Chiu-Wing Chu9Lawrence Ka-sing Wong10Thomas Wai-Hong Leung11Xiang-Yan Chen12The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD, United StatesThe Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD, United StatesDepartment of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaThe Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD, United StatesDepartment of Medical Image Center, Yuebei People's Hospital, Shantou University Medical College, Shantou, ChinaDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong KongDepartment of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong KongDepartment of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong KongDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong KongDepartment of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong KongDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong KongDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong KongDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong KongBackground and Purpose: Intracranial arterial calcification (IAC) has been the focus of much attention by clinicians and researchers as an indicator of intracranial atherosclerosis, but correlations of IAC patterns (intimal or medial) with the presence of atherosclerotic plaques and plaque stability are still a matter of debate. Our study aimed to assess the associations of IAC patterns identified on computed tomography (CT) with the presence of plaque detected on vessel wall magnetic resonance imaging and plaque stability.Materials and Methods: Patients with stroke or transient ischemic attack and intracranial artery stenosis were recruited. IAC was detected and localized (intima or media) on non-contrast CT images. Intracranial atherosclerotic plaques were identified using vessel wall magnetic resonance imaging and matched to corresponding CT images. Associations between IAC patterns and culprit atherosclerotic plaques were assessed by using multivariate regression.Results: Seventy-five patients (mean age, 63.4 ± 11.6 years; males, 46) were included. Two hundred and twenty-one segments with IAC were identified on CT in 66 patients, including 86 (38.9%) predominantly intimal calcifications and 135 (61.1%) predominantly medial calcifications. A total of 72.0% of intimal calcifications coexisted with atherosclerotic plaques, whereas only 10.2% of medial calcifications coexisted with plaques. Intimal calcification was more commonly shown in non-culprit plaques than culprit plaques (25.9 vs. 9.4%, P = 0.008). The multivariate mixed logistic regression adjusted for the degree of stenosis showed that intimal calcification was significantly associated with non-culprit plaques (OR, 2.971; 95% CI, 1.036–8.517; P = 0.043).Conclusion: Our findings suggest that intimal calcification may indicate the existence of a stable form of atherosclerotic plaque, but plaques can exist in the absence of intimal calcification especially in the middle cerebral artery.https://www.frontiersin.org/articles/10.3389/fneur.2021.619233/fullcalcificationatherosclerosisintracranial diseasecomputed tomographymagnetic resonance imaging |
| spellingShingle | Wen-Jie Yang Bruce A. Wasserman Lu Zheng Zhong-Qing Huang Zhong-Qing Huang Jia Li Jill Abrigo Simon Sin-man Wong Michael Tin-cheung Ying Winnie Chiu-Wing Chu Lawrence Ka-sing Wong Thomas Wai-Hong Leung Xiang-Yan Chen Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall Imaging Frontiers in Neurology calcification atherosclerosis intracranial disease computed tomography magnetic resonance imaging |
| title | Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall Imaging |
| title_full | Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall Imaging |
| title_fullStr | Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall Imaging |
| title_full_unstemmed | Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall Imaging |
| title_short | Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall Imaging |
| title_sort | understanding the clinical implications of intracranial arterial calcification using brain ct and vessel wall imaging |
| topic | calcification atherosclerosis intracranial disease computed tomography magnetic resonance imaging |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.619233/full |
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