Mineralizing microangiopathy is a condition characterized by parenchymal cerebral calcifications, and is usually seen in children as a complication of cranial radiotherapy and chemotherapy 1,2.
Mineralizing microangiopathy can affect the brain widely, with typical sites involved including 3:
- corticomedullary junction regions
- lentiform nuclei of the basal ganglia
- dentate nucleus of the cerebellum
CT typically shows calcification in the affected region.
MRI is less sensitive as calcifications are generally not well demonstrated on conventional MRI sequences. T2* sequences, particularly susceptibility weighted imaging (SWI) will demonstrate magnetic susceptibility artifacts in affected areas.
- T1: may show paradoxical hyperintensity in the region of calcification due to surface relaxation mechanism 2
- T2: often inapparent on spin echo sequences
- SWI: signal loss
General imaging differential considerations for corticomedullary calcifications are:
dural arteriovenous fistula (dAVF) with severe venous hypertension
- identical appearance
cortical laminar necrosis
- calcification is cortical
- calcification is leptomeningeal / cortical rather than subcortical
Causes of basal ganglia calcification are discussed separately.
- 1. Computed Tomography & Magnetic Resonance Imaging Of The Whole Body. Elsevier Health Sciences. (2008) ISBN:0323076211. Read it at Google Books - Find it at Amazon
- 2. Shanley DJ. Mineralizing microangiopathy: CT and MRI. Neuroradiology. 1995;37 (4): 331-3. Pubmed citation
- 3. Lewis E, Lee YY. Computed tomography findings of severe mineralizing microangiopathy in the brain. J Comput Tomogr. 1987;10 (4): 357-64. Pubmed citation
- 4. Davis PC, Hoffman JC, Pearl GS et-al. CT evaluation of effects of cranial radiation therapy in children. AJR Am J Roentgenol. 1986;147 (3): 587-92. doi:10.2214/ajr.147.3.587 - Pubmed citation
- 5. Suzuki S, Nishio S, Takata K et-al. Radiation-induced brain calcification: paradoxical high signal intensity in T1-weighted MR images. Acta Neurochir (Wien). 2000;142 (7): 801-4. Pubmed citation
- 6. Metoki T, Mugikura S, Higano S et-al. Subcortical calcification on CT in dural arteriovenous fistula with cortical venous reflux. AJNR Am J Neuroradiol. 2006;27 (5): 1076-8. AJNR Am J Neuroradiol (full text) - Pubmed citation