Correlation between Carotid Arterial Calcium Score and Silent Cerebrovascular Lesions in Obstructive Sleep Apnea Patients: by Using Upper Airway CT and Brain MRI
김문성, 강은주, 배우용, 김종국, 김철훈, 최재형, 김상현, 김대연, 이기남,
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김문성 ( Kim Moon-Sung )
Dong-A University College of Medicine Department of Radiology
강은주 ( Kang Eun-Ju )
Dong-A University College of Medicine Department of Radiology
배우용 ( Bae Woo-Yong )
Dong-A University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
김종국 ( Kim Jong-Kuk )
Dong-A University College of Medicine Department of Neurology
김철훈 ( Kim Chul-Hoon )
Dong-A University College of Medicine Department of Oral and Maxillofacial Surgery
최재형 ( Choi Jae-Hyung )
Dong-A University College of Medicine Department of Neurosurgery
김상현 ( Kim Sang-Hyun )
Dong-A University College of Medicine Department of Radiology
김대연 ( Kim Dae-Yeon )
Dong-A University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
이기남 ( Lee Ki-Nam )
Dong-A University College of Medicine Department of Radiology
Abstract
Purpose: To investigate the relationship between carotid arterial calcium score (CarACS) and silent cerebrovascular lesions in patients with obstructive sleep apnea (OSA).
Materials and Methods: This study involved retrospective evaluation of 60 OSA patients who underwent both upper airway CT and brain MRI. Using polysomnography, several indicators, including apnea index (AI), were used to evaluate the relationship between OSA and silent cerebrovascular lesions. The CarACS was quantified on CT imaging using the modified Agatston method. Silent cerebrovascular lesions were evaluated on brain MRI by grading periventricular hyperintensity (PVH). Various clinical characteristics, including age, were analyzed in each patient.
Results: The number of patients per PVH grade 0, 1, 2, 3, and 4 was 26 (43.3%), 14 (23.3%), 14 (23.3%), 4 (6.7%), and 2 (3.3%), respectively. The mean age, hypertension, smoking status, AI, and CarACS were significantly different among PVH groups (Ps < 0.05). In univariate analysis, the presence of carotid arterial calcification (β = 0.483, p < 0.01), CarACS (β = 0.482, p < 0.01), and age (β = 0.360, p < 0.01) showed a significant association with PVH grade. The mean AI and lowest O2 saturation had statistically weak associations with PVH grade (β = 0.267, p < 0.01; β = ?0.219, p < 0.14, respectively). In multivariate analysis, CarACS was the only factor affecting PVH grade (p < 0.04).
Conclusion: CarACS is associated with the severity of silent cerebrovascular lesions. Therefore, additional analysis of CarACS in OSA patients may provide more information on their cerebrovascular status.
키워드
Obstructive Sleep Apnea; Carotid Arteries; Calcium; Cerebrovascular Disorders; Cerebral Ischemia; Magnetic Resonance Imaging
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