title: Middle Cerebral Artery Calcification: Association With Ischemic Stroke.
abstract: Calcification of the middle cerebral artery (MCA) is uncommon in the healthy elderly. Whether calcification of the MCA is associated with cerebral ischemic stroke remains undetermined. We intended to investigate the association using Agatston calcium scoring of the MCA. This study retrospectively included 354 subjects with ischemic stroke in the MCA territory and 1518 control subjects who underwent computed tomography (CT) of the brain. We recorded major known risk factors for ischemic stroke, including age, gender, hypertension, diabetes mellitus, smoking, hyperlipidemia, and obesity, along with the MCA calcium burden, measured with the Agatston calcium scoring method. Univariate and modified logistic regression analyses were performed to examine the association between the MCA calcification and ischemic stroke. The univariate analyses showed significant associations of ischemic stroke with age, hypertension, diabetes mellitus, smoking, total MCA Agatston score, and the presence of calcification on both or either side of the MCA. Subjects with the presence of MCA calcification on both or either side of the MCA were 8.46 times (95% confidence interval, 4.93-14.53; P < 0.001) more likely to have a cerebral infarct than subjects without MCA calcification after adjustment for the major known risk factors, including age, hypertension, diabetes mellitus, and smoking. However, a higher degree of MCA calcification reflected by the Agatston score was not associated with higher risk of MCA ischemic stroke after adjustment for the confounding factors and presence of MCA calcification. These results suggest that MCA calcification is associated with ischemic stroke in the MCA territory. Further prospective studies are required to verify the clinical implications of the MCA calcification.
authors.affiliation: From 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)..
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Kao
authors.forename: Michelle
authors.initials: M
authors.lastname: Liou
authors.forename: Hsiao-Wen
authors.initials: HW
authors.lastname: Chung
authors.forename: Hua-Shan
authors.initials: HS
authors.lastname: Liu
authors.forename: Ping-Huei
authors.initials: PH
authors.lastname: Tsai
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Chiang
authors.forename: Ming-Chung
authors.initials: MC
authors.lastname: Chou
authors.forename: Giia-Sheun
authors.initials: GS
authors.lastname: Peng
authors.forename: Guo-Shu
authors.initials: GS
authors.lastname: Huang
authors.forename: Hsian-He
authors.initials: HH
authors.lastname: Hsu
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications* / Q000175:diagnosis*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000150:complications* / Q000175:diagnosis*