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Article: Computed Tomography Evaluation of Intracranial Atherosclerosis in Chinese Patients with Transient Ischemic Attack or Minor Ischemic Stroke-Its Distribution and Association with Vascular Risk Factors

TitleComputed Tomography Evaluation of Intracranial Atherosclerosis in Chinese Patients with Transient Ischemic Attack or Minor Ischemic Stroke-Its Distribution and Association with Vascular Risk Factors
Authors
Issue Date2009
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/jstroke
Citation
Journal Of Stroke And Cerebrovascular Diseases, 2009, v. 18 n. 2, p. 158-163 How to Cite?
AbstractObjectives: Intracranial atherosclerosis has been suggested to be common in Asians. We apply a semi-quantitative CT scoring system to evaluate the degree of intracranial atherosclerotic calcification and determine its distribution, severity, and the associated risk factors. The clinical outcome of these patients after a 3-year follow-up was also evaluated. Methods: Sixty consecutive patients diagnosed clinically to have either a transient ischemic attack (TIA) or minor ischemic stroke and underwent early computed tomographic angiography (CTA) were included into the prospective study. Two radiologists evaluated the axial CTA images for any calcification in the precavernous, cavernous and postcavernous segments of intracranial internal carotid artery (ICA), anterior, middle, and posterior cerebral as well as vertebrobasilar 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 for all patients. The worst site (highest composite score) was chosen as the marker of the degree of intracranial atherosclerosis of each patient. The patients were then classified into mild, moderate, and severe groups, according to a composite CT score of 0-2, 3-5, and 6-8, respectively. These findings were gathered with clinical parameters and outcome after a 3-year follow-up period and corresponding statistical analyses were conducted. Results: The most severely affected vessel was found to be intracranial internal carotid arteries, and severe, moderate, and mild atherosclerosis were present in 16 (26.67%), 30 (50%), and 14 (23.33%) patients, respectively. Using multiple logistic regression analysis, diabetes mellitus (odds ratio = 10.6, P value = .004), and age (odds ratio = 1.07, P value = .02) were found to be significant risk factors for severe intracranial atherosclerosis. Two patients in the severe group, 3 patients in the moderate group, and 1 patient in the mild group were found to have stroke or TIA after a 3-year follow-up, but there was no significant difference among the 3 groups. Conclusion: Significant intracranial atherosclerosis as determined by severe CT calcification was common in a cohort of Chinese patients with TIA and minor stroke. Age and diabetes mellitus were independent significant risk factors, and this CT calcification score might serve as an early indicator of intracranial atherosclerotic disease. © 2009 National Stroke Association.
Persistent Identifierhttp://hdl.handle.net/10722/150907
ISSN
2014 Impact Factor: 1.669
2014 SCImago Journal Rankings: 0.706
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKaFung Mak, Hen_US
dc.contributor.authorWong, CWen_US
dc.contributor.authorKaiWing Yau, Ken_US
dc.contributor.authorWong, WMen_US
dc.contributor.authorGu, Jen_US
dc.contributor.authorKhong, PLen_US
dc.contributor.authorPoonLap Chan, Ben_US
dc.date.accessioned2012-06-26T06:14:18Z-
dc.date.available2012-06-26T06:14:18Z-
dc.date.issued2009en_US
dc.identifier.citationJournal Of Stroke And Cerebrovascular Diseases, 2009, v. 18 n. 2, p. 158-163en_US
dc.identifier.issn1052-3057en_US
dc.identifier.urihttp://hdl.handle.net/10722/150907-
dc.description.abstractObjectives: Intracranial atherosclerosis has been suggested to be common in Asians. We apply a semi-quantitative CT scoring system to evaluate the degree of intracranial atherosclerotic calcification and determine its distribution, severity, and the associated risk factors. The clinical outcome of these patients after a 3-year follow-up was also evaluated. Methods: Sixty consecutive patients diagnosed clinically to have either a transient ischemic attack (TIA) or minor ischemic stroke and underwent early computed tomographic angiography (CTA) were included into the prospective study. Two radiologists evaluated the axial CTA images for any calcification in the precavernous, cavernous and postcavernous segments of intracranial internal carotid artery (ICA), anterior, middle, and posterior cerebral as well as vertebrobasilar 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 for all patients. The worst site (highest composite score) was chosen as the marker of the degree of intracranial atherosclerosis of each patient. The patients were then classified into mild, moderate, and severe groups, according to a composite CT score of 0-2, 3-5, and 6-8, respectively. These findings were gathered with clinical parameters and outcome after a 3-year follow-up period and corresponding statistical analyses were conducted. Results: The most severely affected vessel was found to be intracranial internal carotid arteries, and severe, moderate, and mild atherosclerosis were present in 16 (26.67%), 30 (50%), and 14 (23.33%) patients, respectively. Using multiple logistic regression analysis, diabetes mellitus (odds ratio = 10.6, P value = .004), and age (odds ratio = 1.07, P value = .02) were found to be significant risk factors for severe intracranial atherosclerosis. Two patients in the severe group, 3 patients in the moderate group, and 1 patient in the mild group were found to have stroke or TIA after a 3-year follow-up, but there was no significant difference among the 3 groups. Conclusion: Significant intracranial atherosclerosis as determined by severe CT calcification was common in a cohort of Chinese patients with TIA and minor stroke. Age and diabetes mellitus were independent significant risk factors, and this CT calcification score might serve as an early indicator of intracranial atherosclerotic disease. © 2009 National Stroke Association.en_US
dc.languageengen_US
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/jstrokeen_US
dc.relation.ispartofJournal of Stroke and Cerebrovascular Diseasesen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshAsian Continental Ancestry Groupen_US
dc.subject.meshBrain Ischemia - Epidemiologyen_US
dc.subject.meshCalcinosis - Epidemiology - Ethnology - Radiographyen_US
dc.subject.meshCerebral Arteries - Pathology - Physiopathology - Radiographyen_US
dc.subject.meshDisease Progressionen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIntracranial Arteriosclerosis - Epidemiology - Ethnology - Radiographyen_US
dc.subject.meshIschemic Attack, Transient - Epidemiologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPredictive Value Of Testsen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSeverity Of Illness Indexen_US
dc.subject.meshStroke - Epidemiologyen_US
dc.subject.meshTomography, X-Ray Computeden_US
dc.titleComputed Tomography Evaluation of Intracranial Atherosclerosis in Chinese Patients with Transient Ischemic Attack or Minor Ischemic Stroke-Its Distribution and Association with Vascular Risk Factorsen_US
dc.typeArticleen_US
dc.identifier.emailKaFung Mak, H:makkf@hkucc.hku.hken_US
dc.identifier.emailKhong, PL:plkhong@hkucc.hku.hken_US
dc.identifier.authorityKaFung Mak, H=rp00533en_US
dc.identifier.authorityKhong, PL=rp00467en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2008.09.011en_US
dc.identifier.pmid19251193-
dc.identifier.scopuseid_2-s2.0-60749110398en_US
dc.identifier.hkuros155352-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-60749110398&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume18en_US
dc.identifier.issue2en_US
dc.identifier.spage158en_US
dc.identifier.epage163en_US
dc.identifier.eissn1532-8511-
dc.identifier.isiWOS:000264221400012-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridKaFung Mak, H=7004699149en_US
dc.identifier.scopusauthoridWong, CW=26422646800en_US
dc.identifier.scopusauthoridKaiWing Yau, K=26031595200en_US
dc.identifier.scopusauthoridWong, WM=36847934800en_US
dc.identifier.scopusauthoridGu, J=7403129372en_US
dc.identifier.scopusauthoridKhong, PL=7006693233en_US
dc.identifier.scopusauthoridPoonLap Chan, B=26031627200en_US

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