Physiological Intracranial Calcifications in Children: A computed tomography-based study
Faiza Al Hajri1, Srinivasa R Sirasanagandla2, Ammar Boudaka3,4
1Radiology Residency Program, Oman Medical Specialty Board, Muscat, Oman.
Insights
Physiological intracranial calcifications (PICs) are common in children, particularly in the choroid plexus. These findings are important for radiologists to distinguish from serious conditions.
Area of Science:
- Radiology
- Pediatric Imaging
- Neuroscience
Background:
- Physiological intracranial calcifications (PICs) are common findings in brain imaging.
- Understanding the prevalence and distribution of PICs in pediatric populations is crucial for accurate diagnosis.
Purpose of the Study:
- To determine the frequency and distribution of physiological intracranial calcifications (PICs) in a pediatric population.
- To analyze the relationship between age and the occurrence of PICs in children.
Main Methods:
- Retrospective analysis of 460 pediatric brain CT scans (age 0-15 years).
- Assessment for PICs using 3 mm axial images and coronal/sagittal reformats.
- Evaluation of calcification locations including choroid plexus, pineal gland, habenular nucleus, falx cerebri, and tentorium cerebelli.
Main Results:
- PICs were observed in 35.1% of boys and 35.4% of girls.
- The most frequent sites for PICs were the choroid plexus (35.2%), pineal gland (21.1%), and habenular nucleus (13.0%).
- PICs showed a significant increase with age (P <0.001).
Conclusions:
- The choroid plexus is the most common site for PICs in children.
- PICs in the choroid plexus and pineal gland can be present even in infants under one year old.
- Radiologists must be aware of PICs to avoid misdiagnosis as hemorrhage or pathological conditions.
Objectives:
This study aimed to examined the frequency of physiological intracranial calcifications (PICs) in paediatric population using computed tomography (CT).
Methods:
The brain CT scans of consecutive patients (age range: 0-15 years) who had visited Sultan Qaboos University Hospital, Muscat, Oman, from January 2017 to December 2020 were retrospectively assessed for the presence of PICs. The presence of calcifications was identified using 3 mm-thick axial images and coronal and sagittal reformats.
Results:
A total of 460 patients were examined, with a mean age of 6.54 ± 4.94 years. The frequency of PIC in boys and girls was 35.1% and 35.4%, respectively. PICs were most common in choroid plexus, observed in 35.2% (age range: 0.4-15 years, median: 12 years) of subjects, followed by the pineal gland in 21.1% (age range: 0.5-15 years, median: 12 years) and the habenular nucleus in 13.0% of subjects (age range: 2.9-15 years; median: 12 years). PICs were less common in falx cerebri, observed in 5.9% (age range: 2.8-15 years; median: 13 years) of subjects, and tentorium cerebelli, observed in 3.0% (age range: 7-15 years, median: 14 years) of subjects. PICs increased significantly with increase in age (P <0.001).
Conclusion:
Choroid plexus is the most frequent site of calcification. Choroid plexus and pineal gland calcifications may be present in infants younger than one year. Recognising PICs is clinically important for radiologists as they can be mistaken for haemorrhage or pathological entities such as neoplasms or metabolic diseases.
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