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CT-derived density of intracranial arteriosclerosis: a population-based cohort study
Bernhard P Berghout1,2, Robin Y R Camarasa2, Maarten J G Leening1,2,3
1Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.
European Radiology
|January 15, 2026
Summary
Intracranial artery calcification (IAC) density is higher in the anterior compared to the posterior circulation. Key drivers of IAC density include hypertension, lipid-lowering medication use, and smoking, similar to IAC volume.
Area of Science:
- Neuroradiology
- Vascular Biology
- Public Health
Background:
- Coronary artery calcification density is linked to ischemic heart disease risk.
- The relationship between intracranial artery calcifications (IAC) density and cerebrovascular disease risk is not well understood.
- Population-based data on IAC density and its determinants are lacking.
Purpose of the Study:
- To estimate the density distribution of intracranial artery calcifications (IAC) in a community-living cohort.
- To investigate the correlation between IAC density and IAC volume.
- To identify the key determinants of IAC density and compare them with those of IAC volume.
Main Methods:
- Non-contrast CT scans from 2464 individuals were analyzed to measure IAC density.
- Spearman's rank correlation was used to assess the relationship between IAC density and volume.
- Multivariable ordinal regression models were employed to determine associations between risk factors and IAC density.
Main Results:
- The prevalence of IAC was 82.8%, with a median density of 232 HU.
- IAC density showed a moderate correlation with IAC volume (ρ = 0.67).
- Anterior circulation calcifications (ICAC) were denser than posterior circulation calcifications (VBAC).
- Hypertension, lipid-lowering medication use, and smoking were significant determinants of IAC density.
Conclusions:
- IAC density varies significantly between anterior and posterior cerebral circulation arteries.
- While IAC density moderately correlates with volume, its key drivers are similar to those of IAC volume.
- IAC density may aid in differentiating intracranial calcification subtypes and their specific effects on cerebrovascular disease risk.
