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01-03-2022 | Magnetic Resonance Imaging | Original Article

How to look for intracranial calcification in children with neurological disorders: CT, MRI, or both of them?

Authors: Davide Tonduti, Anna Pichiecchio, Carla Uggetti, Stefania Maria Bova, Simona Orcesi, Cecilia Parazzini, Luisa Chiapparini

Published in: Neurological Sciences | Issue 3/2022

Abstract

Background

Intracranial calcification (ICC) is an important diagnostic clue in pediatric neurology. Considering the radiation-induced cancer risk associated with computed tomography (CT), we aim to define the diagnostic value of magnetic resonance imaging (MRI) sequences sensitive to paramagnetic/diamagnetic substances in the detection of ICC, comparing with CT scanning.

Materials and methods

We selected MRI and CT scans performed in children affected by neurological conditions associated with ICC referred to the participating centers between 2005 and 2018. Inclusion criteria were age at neuroradiological investigation < 18 years, availability of good quality CT positive for calcification, and MRI scan that included GE or/and SWI sequences, performed no more than 6 months apart.

Results

Eighty-one patients were included in the study. CT and MRI scans were reviewed by consensus. MRI failed to detect ICC in 14% of the cases. Susceptibility-weighted imaging (SWI) was the best MRI sequence to use in this setting, followed by gradient echo imaging. In 19% of the cases, CT could have been avoided because the identification or monitoring of ICC has not been necessary for the clinical management of the patient.

Conclusion

In the diagnostic workup of pediatric-onset neurological disorders of unknown cause, the first step to look for ICC should be an MRI that includes SWI and GE sequences. If ICC is absent on MRI, brain CT scanning should be performed at least once. When the identification or monitoring of ICC is unlikely to add information useful for patient’s follow-up or treatment, we recommend not performing CT scanning.

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Title: How to look for intracranial calcification in children with neurological disorders: CT, MRI, or both of them?
Authors: Davide Tonduti
Anna Pichiecchio
Carla Uggetti
Stefania Maria Bova
Simona Orcesi
Cecilia Parazzini
Luisa Chiapparini
Publication date: 01-03-2022
Publisher: Springer International Publishing
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Computed Tomography
Computed Tomography
Published in: Neurological Sciences / Issue 3/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-021-05510-w

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Springer Medicine

How to look for intracranial calcification in children with neurological disorders: CT, MRI, or both of them?

Abstract

Background

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

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