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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
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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
 
AuthorsKaFung Mak, H1
Wong, CW1
KaiWing Yau, K1
Wong, WM1
Gu, J1
Khong, PL1
PoonLap Chan, B1
 
Issue Date2009
 
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/jstroke
 
CitationJournal Of Stroke And Cerebrovascular Diseases, 2009, v. 18 n. 2, p. 158-163 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2008.09.011
 
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.
 
ISSN1052-3057
2013 Impact Factor: 1.993
 
DOIhttp://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2008.09.011
 
ISI Accession Number IDWOS:000264221400012
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorKaFung Mak, H
 
dc.contributor.authorWong, CW
 
dc.contributor.authorKaiWing Yau, K
 
dc.contributor.authorWong, WM
 
dc.contributor.authorGu, J
 
dc.contributor.authorKhong, PL
 
dc.contributor.authorPoonLap Chan, B
 
dc.date.accessioned2012-06-26T06:14:18Z
 
dc.date.available2012-06-26T06:14:18Z
 
dc.date.issued2009
 
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.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationJournal Of Stroke And Cerebrovascular Diseases, 2009, v. 18 n. 2, p. 158-163 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2008.09.011
 
dc.identifier.doihttp://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2008.09.011
 
dc.identifier.eissn1532-8511
 
dc.identifier.epage163
 
dc.identifier.hkuros155352
 
dc.identifier.isiWOS:000264221400012
 
dc.identifier.issn1052-3057
2013 Impact Factor: 1.993
 
dc.identifier.issue2
 
dc.identifier.pmid19251193
 
dc.identifier.scopuseid_2-s2.0-60749110398
 
dc.identifier.spage158
 
dc.identifier.urihttp://hdl.handle.net/10722/150907
 
dc.identifier.volume18
 
dc.languageeng
 
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/jstroke
 
dc.publisher.placeUnited States
 
dc.relation.ispartofJournal of Stroke and Cerebrovascular Diseases
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAdult
 
dc.subject.meshAged
 
dc.subject.meshAged, 80 And Over
 
dc.subject.meshAsian Continental Ancestry Group
 
dc.subject.meshBrain Ischemia - Epidemiology
 
dc.subject.meshCalcinosis - Epidemiology - Ethnology - Radiography
 
dc.subject.meshCerebral Arteries - Pathology - Physiopathology - Radiography
 
dc.subject.meshDisease Progression
 
dc.subject.meshFemale
 
dc.subject.meshHumans
 
dc.subject.meshIntracranial Arteriosclerosis - Epidemiology - Ethnology - Radiography
 
dc.subject.meshIschemic Attack, Transient - Epidemiology
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshPredictive Value Of Tests
 
dc.subject.meshRisk Factors
 
dc.subject.meshSeverity Of Illness Index
 
dc.subject.meshStroke - Epidemiology
 
dc.subject.meshTomography, X-Ray Computed
 
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 Factors
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong