The correlation between intracranial arterial calcification and white matter hyperintensities in patients with cerebral small vessel disease
10.3760/cma.j.cn113694-20241105-00712
- VernacularTitle:脑小血管病患者颅内动脉钙化与其脑白质高信号的相关性研究
- Author:
Quan YONG
1
;
Ce ZONG
1
;
Ying YAO
1
;
Zhengrong WU
1
;
Yuan GAO
1
Author Information
1. 郑州大学第一附属医院神经内科，郑州450052
- Publication Type:Journal Article
- Keywords:
Cerebrovascular disorders;
Cerebral small vessel disease;
Intracranial arterial calcification;
White matter hyperintensities
- From:
Chinese Journal of Neurology
2025;58(8):828-836
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation of intracranial arterial calcification (IAC) and its different subtypes with the severity of white matter hyperintensities (WMHs) in patients with cerebral small vessel disease (CSVD).Methods:Consecutive CSVD patients admitted to the Department of Neurology, the First Affiliated Hospital of Zhengzhou University from March 2018 to March 2022 were enrolled. Baseline demographic, laboratory, and imaging data were collected. Based on a developed and validated IAC grading scale using head CT, IAC was classified into intimal and medial types, and further categorized as focal or diffuse based on the extent of involvement. The severity of WMHs on magnetic resonance imaging was assessed using the Fazekas Scale, with patients divided into those with moderate-to-severe (total score>2) and non-moderate-to-severe WMHs (total score≤2). Subgroups were stratified based on baseline characteristics (patients′ sex, age, hypertension history, stroke history, diabetes, coronary heart disease, hyperlipidemia, smoking, and alcohol consumption). Multivariate Logistic regression was used to analyze the correlation between IAC′s subtypes and the severity of WMHs, with forest plots illustrating the interaction between medial IAC and subgroup variables.Results:A total of 490 patients with CSVD who met the inclusion and exclusion criteria were ultimately included, with a age of (60.88±10.99) years, including 162 females (33.1%). Moderate-to-severe WMHs were present in 245 patients (50.0%). Among the 490 CSVD patients, 395 (80.6%) had IAC, including 335 (68.4%) with intimal IAC and 207 (42.2%) with medial IAC. Diffuse IAC was observed in 126 patients (25.7%), all of whom had medial IAC. Intracranial arterial stenosis was present in 271 patients (55.3%). Multivariate Logistic regression showed that IAC ( OR=2.073, 95% CI 1.142-3.761, P=0.016) was significantly associated with moderate-to-severe WMHs and medial IAC ( OR=3.230, 95% CI 1.800-5.797, P<0.001) and advanced age ( OR=1.046, 95% CI 1.019-1.074, P=0.001) were significantly associated with moderate-to-severe WMHs. Subgroup analysis revealed medial IAC had no significant interaction with patients′ gender, age, hypertension, diabetes, coronary heart disease, hyperlipidemia, alcohol or smoking consumption except for stroke history. Conclusion:In the CSVD patients, IAC, especially medial IAC, is significantly associated with the severity of WMHs.
