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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00426

Correlation between intracranial arterial calcification and imaging of cerebral small vessel disease

Yuan-chang Chen1, Xiao-er Wei1, Jing Lu1, Rui-hua Qiao1, Xue-feng Shen1 and  Yue-hua Li1*
  • 1Shanghai Sixth People's Hospital, China

Background and purpose: Vascular calcification is part of the atherosclerotic process. Intracranial artery calcification is closely associated with cerebral small vessel disease (SVD). The present study aimed to investigate the distribution pattern of intracranial arterial calcification and its association with magnetic resonance imaging (MRI) markers of SVD in patients with acute ischemic cerebrovascular disease.

Methods: Two hundred and seventy six consecutive patients with transient ischemic attack (TIA) or acute ischemic stroke who underwent both computed tomography (CT) angiography and MRI were enrolled in this study. Intracranial arterial calcium scores were divided into four severity grades based on the Agatston method. MRI was performed to assess cerebral infarction, white matter hyperintensities (WMHs), lacunes, cerebral microbleeds (CMBs), and enlarged perivascular spaces (EPVSs).

Results: Intracranial artery calcification was present in 200 (72.46%) patients, with the highest prevalence in the internal carotid arteries (ICA) (64.8%). The severity of intracranial arterial calcification was associated with the presence of WMHs (P = 0.0001), lacunes (P = 0.0001), and CMBs (p = 0.005); however, there was no association between calcifications and the presence of EPVSs (P = 0.518). The adjusted odds ratios (ORs) of severe intracranial arterial calcification were: 2.747 for WMH (grade 1–2), 3.422 for WMH (grade 3), 2.902 for lacunes, 2.449 for CMB, 0.88 for EPVS (grade 1), and 0.295 for EPVS (grade 2–4).

Conclusion: Intracranial artery calcification is common in patients with ischemic cerebrovascular disease and the intracranial carotid artery is most frequently affected. Intracranial arterial calcifications might be associated with imaging markers of SVD and are highly correlated with WMHs, lacunes, and CMBs. Quantification of calcification on CT provides additional information on the pathophysiology of SVD. Intracranial arterial calcification could act as a potential marker of SVD.

Keywords: Intracranial arterial disease, Cerebral small vessel disease, intracranial arterial calcification, Magnetic Resonance Imaging, computed tomography angiography

Received: 18 Dec 2018; Accepted: 08 Apr 2019.

Edited by:

Emmanuel Carrera, Faculty of Medicine, University of Geneva, Switzerland

Reviewed by:

Tissa Wijeratne MD FAAN FRACP FAHA FRCP (Edin) FRCP (Lon, The University of Melbourne, Australia
Daniel Bos, Erasmus Medical Center, Erasmus University Rotterdam, Netherlands  

Copyright: © 2019 Chen, Wei, Lu, Qiao, Shen and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Yue-hua Li, Shanghai Sixth People's Hospital, Shanghai, China, liyuehua_0529@163.com