Computed Tomography Evaluation of Intracranial Vascular Calcification in Major Ischemic Stroke Patients (Vascular Territory) - Its Distribution and Association with Vascular Risk Factors: A Retrospective Trial Pipat Chiewvit MD*, Siri-on Tritrakarn MD*, Temporn Kraumak MD*
* Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Affiliation :
Objective : Our objective was to determine the distribution of intracranial atherosclerotic calcification, its association with
risk factors, and cerebrovascular events in patients with major ischemic stroke.
Material and Method: In this retrospective study, 327 patients who underwent CT scan of brain were included and the
clinical parameters were recorded. Two neuroradiologists evaluated the non-contrast axial CT images for any of intracranial
arteries, based on a standard CT scoring system for extent (0-4) and thickness (0-4). The composite CT score for extent and
thickness of these vascular segments or vessels were recorded on all patients.
Results : Based on of MDCT features, 155 major ischemic stroke and 172 non-ischemic stroke were enrolled. The highest
prevalence of calcification was seen in intracranial internal carotid artery (IICA) (73%), and less commonly in the vertebral
artery (8%). There were higher prevalence of intracranial artery calcification in ischemic stroke patients than non-ischemic
stroke patients (82% vs. 52%, p<0.0001). Hypertension (OR = 1.903, 95% CI: 1.019-3.552, p<0.05), intracranialartery
calcification (OR = 2.147, 95% CI: 1.143-4.033, p<0.05), moderate degree of calcification (OR = 2.631, 95% CI: 1.299-5.260,
p<0.05), and severe degree of calcification (OR = 3.479, 95% CI: 1.500-8.068, p<0.05) were found to be independently
associated with ischemic stroke.
Conclusion : Significant intracranial atherosclerosis as determined by severe CT calcification had higher incidence in
ischemic stroke patients. Intracranial artery calcification with moderate and severe degree of calcification and hypertension
were independently significant associated with ischemic stroke. CT calcification score might serve as an indicator of
intracranial atherosclerotic disease and might be useful in predicting ischemic stroke.
Keywords : Computed tomography, Intracranial arterial calcification, CT score, Stroke, Risk factors
