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.
Radiographic features
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
CT typically shows calcification in the affected region.
MRI
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
Differential diagnosis
General imaging differential considerations for corticomedullary calcifications are:
-
dural arteriovenous fistula (dAVF) with severe venous hypertension
- identical appearance
-
cortical laminar necrosis
- calcification is cortical
-
Sturge-Weber syndrome
- calcification is leptomeningeal/cortical rather than subcortical
Causes of basal ganglia calcification are discussed separately.
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