Intracranial physiological calcifications evaluated with cone beam CT

ArticleinDentomaxillofacial Radiology 41(8) · July 2012with 156 Reads
DOI: 10.1259/dmfr/33077422 · Source: PubMed
Abstract
Objectives: The purpose of this study was to evaluate cone beam CT (CBCT) scans for the presence of physiological and pathological intracranial calcifications. Methods: CBCT scans from male and female patients that met our ascertainment criteria were evaluated retrospectively (n=500) for the presence of either physiological or pathological intracranial calcifications. Results: Out of the 500 patients evaluated, 176 had evidence of intracranial physiological calcification (35.2% prevalence), and none had evidence of pathological calcification. There was a 3:2 male-to-female ratio and no ethnic predilection; the ages of affected patients ranged from 13 years to 82 years with a mean age of 52 years. The majority of calcifications appeared in the pineal/habenular region (80%), with some also appearing in the choroid plexus region bilaterally (12%), and a smaller subset appearing in the petroclinoid ligament region bilaterally (8%). Conclusions: Intracranial physiological calcifications can be a common finding on CBCT scans, whereas pathological intracranial calcifications are rare.

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  • ... Further, we hypothesize that calcification of CP causes fibrosis. An increase in the plasma concentration of Ca leads to the calcification of soft tissues (Bender 2009), and intracranial physiological calcification frequently occurs (approximately 35.2%) in adults (Sedghizadeh et al. 2012). Further, majority of physiological calcification occurs in a region occupying 12%-66.2% of CP (Daghighi et al. 2007;Sedghizadeh et al. 2012). ...
    ... An increase in the plasma concentration of Ca leads to the calcification of soft tissues (Bender 2009), and intracranial physiological calcification frequently occurs (approximately 35.2%) in adults (Sedghizadeh et al. 2012). Further, majority of physiological calcification occurs in a region occupying 12%-66.2% of CP (Daghighi et al. 2007;Sedghizadeh et al. 2012). We show here that CPC (which is considered as the physiological calcification) was independent of the calcification markers including Ca, vitamin D, and PTH. ...
    ... Further, we hypothesize that calcification of CP causes fibrosis. An increase in the plasma concentration of Ca leads to the calcification of soft tissues ( Bender 2009), and intracranial physiological calcification frequently occurs (approximately 35.2%) in adults ( Sedghizadeh et al. 2012). Further, majority of physiological calcification occurs in a region occupying 12%-66.2% of CP ( Daghighi et al. 2007;Sedghizadeh et al. 2012). ...
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    The choroid plexus (CP) performs multiple functions such as secretion and reabsorption. CP also acts as the blood-cerebrospinal fluid barrier. Prolidase plays an important role in collagen metabolism by degrading imidodipeptides, in which proline or hydroxyproline residue is located at the C-terminal end. Serum prolidase activity (SPA) may reflect the degree of fibrosis and inflammation. Choroid plexus calcification (CPC) is considered as the physiological calcification of the brain, and CPC is diagnosed by the presence of calcification in the anatomical region on computed tomography (CT). Here, CPC and non-calcified CP were defined by Hounsfield Units (HU) values of > 150 and < 50, respectively. We aimed to measure SPA in subjects with CPC and those with non-calcified CP. This study included 89 subjects who were admitted to the neurology clinic and underwent CT: 44 subjects with CPC and 45 subjects with non-calcified CP. The neurological examination of all subjects was normal; namely, the subjects with CPC were asymptomatic. The SPA level was significantly higher in the CPC group than that in the non-calcified CP group (p < 0.002), and there was a significant positive correlation between vitamin D and SPA levels in the CPC group. In contrast, the vitamin D and parathyroid hormone levels were higher in the CPC group, but the difference was not statically significant (p > 0.05). These findings indicate that SPA is a biomarker for CPC that may be predictive of future brain disease.
  • ... Compression to the neighbouring structures and complication during surgery are some of these problems. 8 Sedghizadeh et al 9 found that 35.2% of the cases had intracranial calcification and most of these calcifications were seen in the characteristic features of the habenular region (80%) and some of them were bilateral in the coroid plexus region (12%). Other studies in the literature have reported that habenular calcification is the most common intracra- nial calcification, 10 and is more common in males than females 11 and pathologic calcification is rare. ...
  • ... The role of computed tomography (CT) is well established in identifying the variety of conditions known to cause calcifications in the dentate nuclei [ Table 1]. [4] If present, it narrows down the differential diagnosis in accordance with the age at presentation, history, and clinical features. ...
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    Dentate nucleus is affected in a wide variety of conditions. Magnetic resonance imaging of the brain is the diagnostic modality of choice for delineating the signal characteristics, which helps in narrowing down a vast list of differentials for conditions affecting the dentate. Computed tomography plays an important role, especially for pathologies associated with calcification of dentate nucleus. The purpose of this essay is to demonstrate the host of conditions associated with imaging abnormalities in dentate nuclei in patients with varied clinical features. © 2018 Indian Journal of Radiology and Imaging | Published by Wolters Kluwer - Medknow.
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    For years, the conventional imaging modalities are generally used in dental practice routine. They provide precious information about dentomaxillofacial region; they also have some limitations such as superimpositions, magnifications, distortions, and low-image quality. Because of these limitations, some pathologies, calcifications, and anatomical variations may be missed. Any findings on a radiographic image which are not related to the research areas of interest could be a description of “incidental findings.” Calcifications are one of these incidental findings. They are asymptomatic and also common in TMJ images. Although most of the calcifications require no treatment, correct identification will reduce further diagnostic assessments. Incidental findings on TMJ images were rare, while examining images for temporomandibular disorders and associated issues, it is important not only to examine the TMJ structures but also to look at the nearby anatomical features to check for evidence of incidental findings pathologies that may have mimicked signs and symptoms of TMJ disorders.
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