Middle Cerebral Artery Calcification: Association With Ischemic Stroke
Hung-Wen Kao1, Michelle Liou, Hsiao-Wen Chung
1From the Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (H-WK, H-WC, S-WC, G-SH, H-HH, C-YC); Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan (H-WK); Institute of Statistical Science, Academia, Taipei, Taiwan Sinica (ML); Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan (H-WC, S-WC); Department of Medical Imaging, Taipei Medical University Hospital, Taipei, Taiwan (H-SL, P-HT, C-YC); Imaging Research Center, Taipei Medical University, Taipei, Taiwan (H-SL, P-HT, C-YC); Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan (H-SL, P-HT, C-YC); Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (M-CC); and Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (G-SP)..
Calcification in the middle cerebral artery (MCA) is linked to ischemic stroke. Presence of MCA calcification significantly increases stroke risk, though the degree of calcification may not further elevate risk.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Calcification of the middle cerebral artery (MCA) is not common in healthy older adults.
- The relationship between MCA calcification and cerebral ischemic stroke is not well-established.
Purpose of the Study:
- To investigate the association between MCA calcification and ischemic stroke in the MCA territory.
- To utilize Agatston calcium scoring for quantifying MCA calcification burden.
Main Methods:
- Retrospective study including 354 ischemic stroke patients and 1518 controls.
- Computed tomography (CT) scans were used to assess MCA calcification via Agatston scoring.
- Logistic regression analysis adjusted for major stroke risk factors.
Main Results:
- Univariate analysis revealed associations between ischemic stroke and age, hypertension, diabetes, smoking, and MCA calcification.
- MCA calcification (on either or both sides) was associated with an 8.46-fold increased likelihood of cerebral infarct.
- Higher Agatston scores did not correlate with increased stroke risk after adjusting for calcification presence and other factors.
Conclusions:
- MCA calcification is significantly associated with ischemic stroke in the MCA territory.
- The mere presence of MCA calcification, rather than its severity, appears to be the key risk factor.
- Further prospective research is needed to confirm clinical implications.
