H Baradaran1,2, P Patel1, G Gialdini2, A Giambrone3, M P Lerario4,2, B B Navi4,2, J K Min5, C Iadecola4,2, H Kamel4,2, A Gupta6,2. 1. From the Departments of Radiology (H.B., P.P., A. Gupta). 2. Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (H.B., G.G., M.P.L., B.B.N., C.I., H.K., A. Gupta). 3. Healthcare Policy and Research (A. Giambrone). 4. Neurology (M.P.L., B.B.N., C.I., H.K.). 5. Dalio Institute of Cardiovascular Imaging (J.K.M.), Weill Cornell Medical College, New York, New York. 6. From the Departments of Radiology (H.B., P.P., A. Gupta) ajg9004@med.cornell.edu.
Abstract
BACKGROUND AND PURPOSE: Calcification of the intracranial vasculature is an independent risk factor for stroke. The relationship between luminal stenosis and calcium burden in the intracranial circulation is incompletely understood. We evaluated the relationship between atherosclerotic calcification and luminal stenosis in the intracranial ICAs. MATERIALS AND METHODS: Using a prospective stroke registry, we identified patients who had both NCCT and CTA or MRA examinations as part of a diagnostic evaluation for ischemic stroke. We used NCCTs to qualitatively (modified Woodcock Visual Score) and quantitatively (Agatston-Janowitz Calcium Score) measure ICA calcium burden and used angiography to measure arterial stenosis. We calculated correlation coefficients between the degree of narrowing and calcium burden measures. RESULTS: In 470 unique carotid arteries (235 patients), 372 (79.1%) had atherosclerotic calcification detectable on CT compared with 160 (34%) with measurable arterial stenosis on CTA or MRA (P < .001). We found a weak linear correlation between qualitative (R = 0.48) and quantitative (R = 0.42) measures of calcium burden and the degree of luminal stenosis (P < .001 for both). Of 310 ICAs with 0% luminal stenosis, 216 (69.7%) had measurable calcium scores. CONCLUSIONS: There is a weak correlation between intracranial atherosclerotic calcium scores and luminal narrowing, which may be explained by the greater sensitivity of CT than angiography in detecting the presence of measurable atherosclerotic disease. Future studies are warranted to evaluate the relationship between stenosis and calcium burden in predicting stroke risk.
BACKGROUND AND PURPOSE:Calcification of the intracranial vasculature is an independent risk factor for stroke. The relationship between luminal stenosis and calcium burden in the intracranial circulation is incompletely understood. We evaluated the relationship between atherosclerotic calcification and luminal stenosis in the intracranial ICAs. MATERIALS AND METHODS: Using a prospective stroke registry, we identified patients who had both NCCT and CTA or MRA examinations as part of a diagnostic evaluation for ischemic stroke. We used NCCTs to qualitatively (modified Woodcock Visual Score) and quantitatively (Agatston-Janowitz Calcium Score) measure ICAcalcium burden and used angiography to measure arterial stenosis. We calculated correlation coefficients between the degree of narrowing and calcium burden measures. RESULTS: In 470 unique carotid arteries (235 patients), 372 (79.1%) had atherosclerotic calcification detectable on CT compared with 160 (34%) with measurable arterial stenosis on CTA or MRA (P < .001). We found a weak linear correlation between qualitative (R = 0.48) and quantitative (R = 0.42) measures of calcium burden and the degree of luminal stenosis (P < .001 for both). Of 310 ICAs with 0% luminal stenosis, 216 (69.7%) had measurable calcium scores. CONCLUSIONS: There is a weak correlation between intracranial atheroscleroticcalcium scores and luminal narrowing, which may be explained by the greater sensitivity of CT than angiography in detecting the presence of measurable atherosclerotic disease. Future studies are warranted to evaluate the relationship between stenosis and calcium burden in predicting stroke risk.
Authors: Leslie Bleeker; Henk A Marquering; René van den Berg; Paul J Nederkoorn; Charles B Majoie Journal: Neuroradiology Date: 2011-12-30 Impact factor: 2.804
Authors: G Sangiorgi; J A Rumberger; A Severson; W D Edwards; J Gregoire; L A Fitzpatrick; R S Schwartz Journal: J Am Coll Cardiol Date: 1998-01 Impact factor: 24.094
Authors: Ye Qiao; Zeeshan Anwar; Jarunee Intrapiromkul; Li Liu; Steven R Zeiler; Richard Leigh; Yiyi Zhang; Eliseo Guallar; Bruce A Wasserman Journal: Stroke Date: 2016-01-07 Impact factor: 7.914
Authors: Robert Detrano; Alan D Guerci; J Jeffrey Carr; Diane E Bild; Gregory Burke; Aaron R Folsom; Kiang Liu; Steven Shea; Moyses Szklo; David A Bluemke; Daniel H O'Leary; Russell Tracy; Karol Watson; Nathan D Wong; Richard A Kronmal Journal: N Engl J Med Date: 2008-03-27 Impact factor: 91.245