282例颈动脉钙化与脑小血管病MRI总负荷评分的关联性

Association between carotid calcification and MRI overall burden in 282 cases of cerebral small vessel disease

目的探讨颈动脉钙化与脑小血管病(CSVD)MRI总负荷评分的关联性。方法回顾性分析2020年1月至2022年1月行颈动脉CTA和颅脑MRI检查的282例CSVD患者的相关资料,评估颈动脉钙化情况(有无钙化、数目、位置、形态和环征)和CSVD总负荷评分(包括腔隙、脑白质高信号、微出血、血管周围间隙扩大)。应用有序多分类Logistic回归分析明确颈动脉钙化与CSVD总负荷的关联性。结果共125例(44.3%)患者存在颈动脉钙化,随着颈动脉钙化发生率增加,CSVD总负荷评分增高,差异有统计学意义(χ^(2)=13.814,P=0.003),不同CSVD总负荷组的钙化数目(χ^(2)=16.754,P=0.010)、钙化位置(χ^(2)=17.776,P=0.007)、钙化形态(χ^(2)=28.943,P<0.001)存在统计学差异,而环征在各组间差异无统计学意义(χ^(2)=4.867,P=0.182)。CSVD 3+组的多发钙化、表面钙化、厚钙化/混合钙化的发生率较CSVD 0组增加。校正年龄、性别、高血压、糖尿病、高血脂、颈动脉狭窄程度、重构指数后,颈动脉钙化是CSVD总负荷的独立危险因素(OR=3.687,95%CI:1.013~13.423,P=0.048)。结论颈动脉钙化与CSVD总负荷密切相关,可作为CSVD严重程度的预测指标,为CSVD患者的临床防治提供依据。

Objective To investigate the association between carotid calcification and total burden of cerebral small vessel disease(CSVD).Methods Clinical data of 282 CSVD patients who underwent both computed tomography angiography(CTA)and magnetic resonance imaging(MRI)during Jan.2020 and Jan.2022 were retrospectively analyzed.Characteristics of carotid calcification(presence,size,number,location,and rim sign)and CSVD total burden(lacunes,white matter hyperintensities,microbleeds,enlarged perivascular space)were assessed.The association between carotid calcification and total burden of CSVD was determined with ordinal multivariable logistic regression.Results Carotid calcification was detected in 125(44.3%)patients.The total burden of CSVD rose significantly with the increasing incidence of carotid calcification(χ^(2)=13.814,P=0.003).There were significant differences in the number(χ^(2)=16.754,P=0.010),location(χ^(2)=17.776,P=0.007)and size(χ^(2)=28.943,P<0.001)of calcification in different CSVD total burden groups,while no significant difference was discovered in rim sign(χ^(2)=4.867,P=0.182).Compared with CSVD 0 group,CSVD 3+group showed higher incidences of multiple,surface and thick/mixed calcifications.After age,gender,hypertension,diabetes,hyperlipidemia and carotid artery stenosis were adjusted and indexes were remodeled,carotid calcification was an independent risk factor for CSVD total burden(OR=3.687,95%CI:1.013-13.423,P=0.048).Conclusion Carotid calcification is closely related to the CSVD total burden,which can act as a potential predictor of the severity of CSVD and help the clinical prevention and treatment.