İntrakraniyal fizyolojik kalsifikasyonlar ve taklitçiler

Özet

İntrakraniyal kalsifikasyonlar kontrastsız BT’de belirginleşir; çocukta yaş, simetri, anatomik yerleşim ve dağılım fizyolojik odakları patolojiden ayırmaya yardım eder. Pineal bez, habenula, koroid pleksus ve dural katlantılar tipik fizyolojik yerlerdir. Parankim içi, damar boyunca veya yaygın kalsifikasyonlar enfeksiyöz, vasküler, metabolik ya da neoplastik nedenleri gündeme getirir. Beklenmedik dağılımı normal varyant saymak altta yatan hastalığın gözden kaçmasına neden olabilir.

Faz ve pencere

Kontrastsız tanısal

Kalsiyum yüksek atenüasyonlu odaklar olarak en iyi kontrastsız seride ayırt edilir; kontrastlı görüntü damar veya dura ile ilişkisini netleştirebilse de fizyolojik kalsifikasyon sorusunda rutin faz değildir.

Önerilen pencereler: Beyin (G 80 / M 40), Kemik (G 1800 / M 400).

BT bulguları

• Pineal bez ve habenula çevresindeki kompakt orta hat kalsifikasyonu yaşla birlikte görülebilen fizyolojik dağılımdır.
• Koroid pleksus kalsifikasyonu lateral ventriküllerin atriumlarında, çoğunlukla iki taraflı ve simetrik izlenir.
• Falks ve tentoryum boyunca ince çizgisel kalsifikasyonlar dural yerleşimlidir.
• Bazal gangliyonlarda iki taraflı, simetrik mineralizasyon parankimal dağılımdır; klinik/metabolik bağlamla birlikte yorumlanır.
• Girusları izleyen çizgisel veya giriform kalsifikasyonlar kortikal yüzey boyunca dağılım gösterir.
• Tek taraflı damar hattı boyunca serpijinöz kalsifikasyon kronik vasküler lezyon veya malformasyonla ilişkili olabilir.
• Kitle içinde kümeli, kaba veya düzensiz kalsifikasyon neoplastik ya da gelişimsel taklitçileri düşündürür.

Ölçütler ve sınıflamalar

Dağılıma göre kalsifikasyon paterni

Fizyolojik/yaşa bağlı; parankimal; vasküler; neoplastik veya enfeksiyöz dağılımlar anatomik yer ve morfolojiyle tarif edilir. Bu bir BT raporlama yaklaşımıdır, tek başına hastalık derecelemesi değildir.

Normalde

Aynı düzeyde normal BT’de pineal odak orta hatta, koroid pleksus odakları ventrikül atriumlarında ve dural mineralizasyon falks/tentoryum boyunca sınırlı görünür. Simetriyi, kalsifikasyonun anatomik kompartımanını ve çevresinde kitle, ödem ya da ventrikül deformasyonu olup olmadığını karşılaştır.

Ayırıcı tanı

Konjenital enfeksiyon

periventriküler kalsifikasyonlar ve eşlik eden beyin hacim/gelişim değişiklikleri tanıyı destekleyebilir.

Sturge–Weber sendromu

kortikal giriform kalsifikasyon, çoğunlukla tek hemisferde hacim kaybı ve sulkal belirginlikle birliktedir.

Tüberoskleroz

subependimal nodül ve kortikal tüberlerde kalsifikasyon görülebilir.

Pineal bölge tümörü

bezin beklenen küçük orta hat odağından farklı olarak kitle etkisi veya yer değiştirmiş kalsifikasyon olabilir.

Arteriovenöz malformasyon

serpijinöz damar yapıları ve ilişkili parankimal kalsifikasyonlar eşlik edebilir.

Tuzaklar

• Koroid pleksus kalsifikasyonunu intraventriküler kanama sanma; atriumlarda çift taraflı benzer odak ve kan ürünüyle uyumsuz dağılımı kontrol et.
• Pineal orta hat kalsifikasyonunun yer değiştirmesi kitle etkisi ipucu olabilir; odak çevresindeki pineal bölgeyi ve ventrikülleri izle.
• Bazal gangliyon mineralizasyonunu yalnız BT yoğunluğuna bakarak fizyolojik sayma; simetri, yaygınlık, yaş ve klinik bağlamla eşleştir.
• İntrakraniyal kalsifikasyonları BT’de parankim veya damar içindeki yerleşimlerine ve dağılımlarına göre değerlendir.

Kendini dene

1. İki taraflı atrial yerleşimli, koroid pleksus içinde sınırlı odakların yorumu en olası nedir?

   • Fizyolojik kalsifikasyon
   • Ventrikül içi kanama
   • Pineal tümör
   • Kortikal displazi
   Cevabı göster

   Fizyolojik kalsifikasyon. Atriumlardaki simetrik koroid pleksus kalsifikasyonları tipik fizyolojik dağılımdır. Kanama genellikle pleksusla sınırlı, eşlenik mineralize odaklar şeklinde görünmez.

2. Tek hemisferde kortikal girusları izleyen kalsifikasyon hangi taklitçiyle uyumludur?

   • Sturge–Weber
   • Tüberoskleroz
   • Konjenital CMV
   • Pineal teratom
   Cevabı göster

   Sturge–Weber. Tek taraflı giriform kortikal kalsifikasyon Sturge–Weber paternini düşündürür. Tüberoskleroz daha çok kortikal tüberler/subependimal nodüllerle, konjenital enfeksiyon ise sıklıkla periventriküler dağılımla tanınır.

Kaynaklar

Bu sayfadaki 37 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla tek tek karşılaştırıldı; 1 cümle bu karşılaştırmada düzeltildi (2026-10-08).

1. Imaging and physiology across the high–low cerebrospinal fluid pressure spectrum: Navigating diagnostic uncertainty in headache practicepmc.ncbi.nlm.nih.gov
2. Imaging findings of diabetic complications from head to toe: a comprehensive radiologic reviewpmc.ncbi.nlm.nih.gov
3. Spontaneous Intracranial Hypotension and CSF-Venous Fistulae: from Diagnostic Imaging to Interventional Managementpmc.ncbi.nlm.nih.gov
4. Monogenic Mimics of Neuroinflammatory Phenotypes in Children and Young Adultspmc.ncbi.nlm.nih.gov
5. Advances of MR imaging in glioma: what the neurosurgeon needs to knowpmc.ncbi.nlm.nih.gov
6. Intracranial calcifications in childhood: Part 2.pubmed.ncbi.nlm.nih.gov
7. Ossifying fibroma of the ethmoid and sphenoid sinuses: A report of a rare case and literature review.pubmed.ncbi.nlm.nih.gov
8. Guidelines for standard operation of imaging modalities in orbital diseases (2024).pubmed.ncbi.nlm.nih.gov
9. Neuroimaging of pediatric tumors of the sellar region-A review in light of the 2021 WHO classification of tumors of the central nervous system.pubmed.ncbi.nlm.nih.gov
10. Physiological Intracranial Calcifications in Children: A computed tomography-based study.pubmed.ncbi.nlm.nih.gov
11. Intracranial calcifications in childhood: Part 1.pubmed.ncbi.nlm.nih.gov
12. Intracranial Calcification Associated with 3-Methylcrotonyl-CoA Carboxylase Deficiency.pubmed.ncbi.nlm.nih.gov
13. Paediatric cranial ultrasound: abnormalities of the brain in term neonates and young infants.pubmed.ncbi.nlm.nih.gov
14. Pediatric CLIPPERS: Expanding the Neuroimaging Spectrum of a Rare Steroid-Responsive Neuroinflammatory Syndrome-A Systematic Review.pubmed.ncbi.nlm.nih.gov
15. Insights from a novel monogenic autoinflammatory disease: overview of a multicentric European cohort of 38 patients with COPA syndrome.pubmed.ncbi.nlm.nih.gov
16. Multimodal imaging in neuro-ophthalmology.pubmed.ncbi.nlm.nih.gov
17. Study of Intraoperative Squash Cytology of Intracranial and Spinal Cord Lesions with Histopathological Correlation.pubmed.ncbi.nlm.nih.gov
18. Sinonasal and skull base phosphaturic mesenchymal tumours: a case series and narrative review.pubmed.ncbi.nlm.nih.gov
19. Hyperthyroidism-Induced Dural Venous Sinus Thrombosis: A Case Report.pubmed.ncbi.nlm.nih.gov
20. Change in Emergency Department Length of Stay following Routine Adoption of Dual-Energy CT to Differentiate Intracranial Hemorrhage from Calcification.pubmed.ncbi.nlm.nih.gov
21. Spot Sign in Intracerebral Hemorrhage: Critical Reappraisal and Future Clinical Implications.pubmed.ncbi.nlm.nih.gov
22. Fetal intracranial hemorrhage and infarct: Main sonographic and MRI characteristics: A review article.pubmed.ncbi.nlm.nih.gov
23. Intracranial calcifications on CT: an updated review.pubmed.ncbi.nlm.nih.gov
24. Cranial ultrasound for beginners.pubmed.ncbi.nlm.nih.gov
25. Artificial Intelligence-Assisted Segmentation of a Falx Cerebri Calcification on Cone-Beam Computed Tomography: A Case Report.pubmed.ncbi.nlm.nih.gov
26. Meningioma: Molecular Updates from the 2021 World Health Organization Classification of CNS Tumors and Imaging Correlates.pubmed.ncbi.nlm.nih.gov
27. Primary central nervous system lymphoma: Imaging features and differential diagnosis.pubmed.ncbi.nlm.nih.gov
28. Rare Presentation of Homozygous S<i>LC20A2</i> Mutations Causing Intra-Arterial Cerebral Vasculopathy and Stroke in Infancy: Case Report and Review of the Literature.pubmed.ncbi.nlm.nih.gov
29. Prosthodontic rehabilitation in Fahr's syndrome: clinical challenges and oral manifestations.pubmed.ncbi.nlm.nih.gov
30. Basal Ganglia Calcifications for Nephrologists: Fahr/Primary Familial Brain Calcification (PFBC) at the Interface of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) and Hypoparathyroidism.pubmed.ncbi.nlm.nih.gov
31. A double threat: CNS toxoplasmosis and CMV encephalitis in a heart transplant recipientpubmed.ncbi.nlm.nih.gov
32. Longitudinal Neuroimaging of a Pediatric Patient With Sturge-Weber Syndrome: From Birth to Adolescence.pubmed.ncbi.nlm.nih.gov
33. Accidental finding of Sturge-Weber syndrome presented to the emergency department with persistent seizures: an unusual case report from Somalia.pubmed.ncbi.nlm.nih.gov
34. Diagnosis and Management of Parotid Gland Arteriovenous Malformation: A Case Report.pubmed.ncbi.nlm.nih.gov
35. A compendium of male breast imaging: The road less traveled.pubmed.ncbi.nlm.nih.gov
36. Intracranial cerebrovascular lesions on T2-weighted magnetic resonance imaging.pubmed.ncbi.nlm.nih.gov
37. Contemporary Clinical Definitions, Differential Diagnosis, and Novel Predictive Tools for Renal Cell Carcinoma.pubmed.ncbi.nlm.nih.gov
38. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.pubmed.ncbi.nlm.nih.gov
39. Spontaneous bacteremia and spontaneous bacterial peritonitis share similar prognosis in patients with cirrhosis: a cohort study.pubmed.ncbi.nlm.nih.gov
40. Head Trauma Mechanisms and Neuroimaging Findings in Psychiatric Inpatients Referred for Neurosurgical Consultation.pubmed.ncbi.nlm.nih.gov
41. Unique presentation of superficial siderosis of the central nervous system following pituitary tumor surgery: a case report and literature review.pubmed.ncbi.nlm.nih.gov
42. Telovelar Approach for Fourth-Ventricular Epidermoid Cyst: Anatomical Respect, Functional Recovery, and Long-Term Stability.pubmed.ncbi.nlm.nih.gov
43. Commentary: an eye on PET quantification.pubmed.ncbi.nlm.nih.gov
44. High-affinity alphavbeta3 integrin targeted optical probe as a new imaging biomarker for early atherosclerosis: initial studies in Watanabe rabbits.pubmed.ncbi.nlm.nih.gov
45. Prenatal diagnosis and outcomes of fetal cardiac tumors: a 10-year single-center study of 81 cases.pubmed.ncbi.nlm.nih.gov
46. Carotid plaque vulnerability and circle of Willis anatomy predict ipsilateral brain infarcts and long-term mortality in carotid endarterectomy patients.pubmed.ncbi.nlm.nih.gov
47. Non-Atherosclerotic and Genetic Intracranial Stenoses: Diagnostic Challenges and Emerging Genetic Insights.pubmed.ncbi.nlm.nih.gov
48. Case Report: The cystic masquerade in type 1 Von Hippel-Lindau disease: coexisting clear cell renal cell carcinoma and an imaging-suspected pancreatic neuroendocrine tumor.pubmed.ncbi.nlm.nih.gov
49. Comparative Analysis of Magnetic Resonance Spectroscopy and Post-contrast Magnetic Resonance Imaging in the Evaluation of Intracranial Ring-Enhancing Lesions.pubmed.ncbi.nlm.nih.gov
50. Low-flow vascular malformations without arteriovenous shunting of the central nervous system: a pictorial review.pubmed.ncbi.nlm.nih.gov
51. Congenital Toxoplasmosis With Atypical Neuroimaging: Hydrocephalus and Bilateral Chorioretinitis Without Intracranial Calcifications.pubmed.ncbi.nlm.nih.gov
52. Neonatal Aicardi-Goutières syndrome presenting with macrophage activation syndrome-like hyperinflammation and severe congenital glaucoma: a case report.pubmed.ncbi.nlm.nih.gov
53. Sturge-Weber Syndrome: A Narrative Review of Clinical Presentation and Updates on Management.pubmed.ncbi.nlm.nih.gov
54. GNAQ/GNA11 Mosaicism Is Associated with Abnormal Serum Calcium Indices and Microvascular Neurocalcification.pubmed.ncbi.nlm.nih.gov
55. Prenatal magnetic resonance imaging findings of tuberous sclerosis complex in fetuses.pubmed.ncbi.nlm.nih.gov
56. Delayed Diagnosis of Tuberous Sclerosis Complex: A Case Report of Abdominal Distension, Pain, and Severe Anemia.pubmed.ncbi.nlm.nih.gov
57. Transmantle sign-like calcified radial lesion on CT serves as a potential imaging feature for epileptogenic foci in tuberous sclerosis complex: a Case Report.pubmed.ncbi.nlm.nih.gov
58. Spinal granulocytic sarcoma with both extradural and intradural involvement: a case report.pubmed.ncbi.nlm.nih.gov
59. Primary intracranial adenocarcinoma associated with an epidermoid cyst: a case report and literature review.pubmed.ncbi.nlm.nih.gov
60. Case Report: A case series of Lhermitte-Duclos disease with surgical intervention.pubmed.ncbi.nlm.nih.gov
61. Vascular Malformations and Tumors: A Review of Classification and Imaging Features for Cardiothoracic Radiologists.pubmed.ncbi.nlm.nih.gov
62. Unruptured Arteriovenous Malformations in the Multidetector Computed Tomography Era: Frequency of Detection and Predictable Failures.pubmed.ncbi.nlm.nih.gov
63. AOSNP-ADAPTR resource level-based recommendations on practical diagnostic strategies for medulloblastomas and other embryonal tumors.pubmed.ncbi.nlm.nih.gov
64. Hydrocephalus: historical analysis and considerations for treatment.pubmed.ncbi.nlm.nih.gov
65. Calcified Pilocytic Astrocytomas and Calcifying Pseudoneoplasms of the Neuraxis: A Diagnostic Challenge.pubmed.ncbi.nlm.nih.gov
66. Primary adrenal mature cystic teratoma: A rare retroperitoneal tumor with two decades of indolent growth.pubmed.ncbi.nlm.nih.gov
67. Combined with chemotherapy and radiotherapy is effective in improving prognosis: a case of primary mediastinal embryonal carcinoma.pubmed.ncbi.nlm.nih.gov
68. Basal Ganglia Calcification With Treatment-Resistant Hypocalcaemia and Persistent Psychosis in an 18-Year-Old: A Case Report.pubmed.ncbi.nlm.nih.gov
69. Amyloid-induced mineralization: From biological systems to biomimetic materials.pubmed.ncbi.nlm.nih.gov
70. Case Report: Developmental-like skeletal deformities and transient osteosclerosis as rare presentations of primary hyperparathyroidism.pubmed.ncbi.nlm.nih.gov
71. Sphenoid fungal rhinosinusitis across the disease spectrum: a case series of non-invasive fungal ball and fatal acute invasive fungal rhinosinusitis.pubmed.ncbi.nlm.nih.gov
72. Cardiovascular Outcomes Associated with Romosozumab Versus Denosumab in Chronic Kidney Disease.pubmed.ncbi.nlm.nih.gov
73. Diagnostic imaging and emerging image-guided neurointervention in brain tumors: a narrative review.pubmed.ncbi.nlm.nih.gov
74. Cerebrospinal Fluid Shunts: An Updated Radiologic Review of Devices, Malfunctions, and Complications.pubmed.ncbi.nlm.nih.gov
75. Society for Cardiovascular Magnetic Resonance 2024 Cases of SCMR case series.pubmed.ncbi.nlm.nih.gov
76. Pediatric Meningeal Diseases: What Radiologists Need to Know.pubmed.ncbi.nlm.nih.gov
77. Storage diseases with hypertrophic cardiomyopathy phenotype.pubmed.ncbi.nlm.nih.gov
78. Long-term safety and effectiveness of the "OptEase" vena cava filter.pubmed.ncbi.nlm.nih.gov
79. Leptomeningeal metastasis with sturge-weber syndrome-like gyriform calcification on imaging: a case report.pubmed.ncbi.nlm.nih.gov
80. Undiagnosed Epileptic Case Since Childhood of Sturge-Weber Syndrome: First Case Report from Somalia.pubmed.ncbi.nlm.nih.gov
81. Imaging and physiology across the high-low cerebrospinal fluid pressure spectrum: Navigating diagnostic uncertainty in headache practice.pubmed.ncbi.nlm.nih.gov
82. Spontaneous Intracranial Hypotension and CSF-Venous Fistulae: from Diagnostic Imaging to Interventional Management.pubmed.ncbi.nlm.nih.gov
83. Monogenic Mimics of Neuroinflammatory Phenotypes in Children and Young Adults: An Evolving Landscape.pubmed.ncbi.nlm.nih.gov
84. Artifact-Controlled Multi-Vertebral Transfer Learning Ensemble for Patient-Level Three-Class Osteoporosis Screening Using Thoracoabdominal CT-Derived Lumbar Images.pubmed.ncbi.nlm.nih.gov
85. Extended Transoral Resection of Anterior Commissure Tumors in a Canine Model: Impact on Laryngeal Framework, Glottis, and Vocal Function.pubmed.ncbi.nlm.nih.gov
86. Voxel-wise deep learning segmentation of hydroxyapatite and iodine in spectral photon-counting CT: A quantitative phantom study.pubmed.ncbi.nlm.nih.gov
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88. Simultaneous Burr hole drainage and middle meningeal artery occlusion through a single incision for chronic subdural hematoma guided by 3D reconstruction.pubmed.ncbi.nlm.nih.gov
89. Sphenoid Temporal Meningioma With Granular Cell Features and Extracranial Infratemporal Extension.pubmed.ncbi.nlm.nih.gov
90. Fatal Injuries Caused by Falling Trees: Correlation Between Postmortem Computed Tomography and Forensic Autopsy Findings in Eight Cases.pubmed.ncbi.nlm.nih.gov
91. Theragnostic Use of Radiolabelled Dota-Peptides in Meningioma: From Clinical Demand to Future Applications.pubmed.ncbi.nlm.nih.gov
92. Orbital tumours and tumour-like lesions: exploring the armamentarium of multiparametric imaging.pubmed.ncbi.nlm.nih.gov
93. Rare anatomical localizations of hydatid cysts (2020-2025): Narrative review of presentation, imaging, and management.pubmed.ncbi.nlm.nih.gov

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