How to look for intracranial calcification in children with neurological disorders: CT, MRI, or both of them?
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/di...
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| Veröffentlicht in: | Neurological sciences 2022-03, Vol.43 (3), p.2043-2050 |
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| creator | Tonduti, Davide Pichiecchio, Anna Uggetti, Carla Bova, Stefania Maria Orcesi, Simona Parazzini, Cecilia Chiapparini, Luisa |
| description | 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 |
| doi_str_mv | 10.1007/s10072-021-05510-w |
| format | Article |
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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.</description><identifier>ISSN: 1590-1874</identifier><identifier>EISSN: 1590-3478</identifier><identifier>DOI: 10.1007/s10072-021-05510-w</identifier><identifier>PMID: 34383160</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Calcification ; Calcification (ectopic) ; Calcinosis - complications ; Calcinosis - diagnostic imaging ; Child ; Children ; Computed tomography ; Humans ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Medical imaging ; Medicine ; Medicine & Public Health ; Nervous System Diseases - diagnostic imaging ; Nervous System Diseases - etiology ; Neuroimaging ; Neurological diseases ; Neurological disorders ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Original Article ; Patients ; Pediatrics ; Psychiatry ; Scanning ; Tomography, X-Ray Computed</subject><ispartof>Neurological sciences, 2022-03, Vol.43 (3), p.2043-2050</ispartof><rights>Fondazione Società Italiana di Neurologia 2021</rights><rights>2021. Fondazione Società Italiana di Neurologia.</rights><rights>Fondazione Società Italiana di Neurologia 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-c65201995ec91ffd4e6ba7c1d74b4e4fe282d096380d3d19c1f19067bfdcf773</citedby><cites>FETCH-LOGICAL-c375t-c65201995ec91ffd4e6ba7c1d74b4e4fe282d096380d3d19c1f19067bfdcf773</cites><orcidid>0000-0001-9371-7454</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10072-021-05510-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10072-021-05510-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34383160$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tonduti, Davide</creatorcontrib><creatorcontrib>Pichiecchio, Anna</creatorcontrib><creatorcontrib>Uggetti, Carla</creatorcontrib><creatorcontrib>Bova, Stefania Maria</creatorcontrib><creatorcontrib>Orcesi, Simona</creatorcontrib><creatorcontrib>Parazzini, Cecilia</creatorcontrib><creatorcontrib>Chiapparini, Luisa</creatorcontrib><title>How to look for intracranial calcification in children with neurological disorders: CT, MRI, or both of them?</title><title>Neurological sciences</title><addtitle>Neurol Sci</addtitle><addtitle>Neurol Sci</addtitle><description>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.</description><subject>Calcification</subject><subject>Calcification (ectopic)</subject><subject>Calcinosis - complications</subject><subject>Calcinosis - diagnostic imaging</subject><subject>Child</subject><subject>Children</subject><subject>Computed tomography</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nervous System Diseases - diagnostic imaging</subject><subject>Nervous System Diseases - etiology</subject><subject>Neuroimaging</subject><subject>Neurological diseases</subject><subject>Neurological disorders</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Psychiatry</subject><subject>Scanning</subject><subject>Tomography, X-Ray Computed</subject><issn>1590-1874</issn><issn>1590-3478</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kE1LxDAQhoMofv8BDxLwanWmSZvWi8iirqAIsvfQ5mM32m006bL47826q968zAzMM-_AQ8gJwgUCiMu4qnkGOWZQFAjZcovsY1FDxriotjczVoLvkYMYXwEAObJdssc4qxiWsE_mY7-kg6ed92_U-kBdP4RGhaZ3TUdV0ylnnWoG5_u0omrmOh1MT5dumNHeLILv_DQBHdUu-qBNiFd0NDmnTy8P5zTltT6B3tJhZubXR2THNl00x5t-SCZ3t5PROHt8vn8Y3TxmioliyFRZ5IB1XRhVo7Wam7JthEIteMsNtyavcg11ySrQTGOt0GINpWitVlYIdkjO1rHvwX8sTBzkq1-EPn2UecmQVTnwFZWvKRV8jMFY-R7cvAmfEkGu1Mq1YJkEy2_BcpmOTjfRi3Zu9O_Jj9EEsDUQ06qfmvD3-5_YL1mohoE</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Tonduti, Davide</creator><creator>Pichiecchio, Anna</creator><creator>Uggetti, Carla</creator><creator>Bova, Stefania Maria</creator><creator>Orcesi, Simona</creator><creator>Parazzini, Cecilia</creator><creator>Chiapparini, Luisa</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><orcidid>https://orcid.org/0000-0001-9371-7454</orcidid></search><sort><creationdate>20220301</creationdate><title>How to look for intracranial calcification in children with neurological disorders: CT, MRI, or both of them?</title><author>Tonduti, Davide ; Pichiecchio, Anna ; Uggetti, Carla ; Bova, Stefania Maria ; Orcesi, Simona ; Parazzini, Cecilia ; Chiapparini, Luisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-c65201995ec91ffd4e6ba7c1d74b4e4fe282d096380d3d19c1f19067bfdcf773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Calcification</topic><topic>Calcification (ectopic)</topic><topic>Calcinosis - complications</topic><topic>Calcinosis - diagnostic imaging</topic><topic>Child</topic><topic>Children</topic><topic>Computed tomography</topic><topic>Humans</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nervous System Diseases - diagnostic imaging</topic><topic>Nervous System Diseases - etiology</topic><topic>Neuroimaging</topic><topic>Neurological diseases</topic><topic>Neurological disorders</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Psychiatry</topic><topic>Scanning</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tonduti, Davide</creatorcontrib><creatorcontrib>Pichiecchio, Anna</creatorcontrib><creatorcontrib>Uggetti, Carla</creatorcontrib><creatorcontrib>Bova, Stefania Maria</creatorcontrib><creatorcontrib>Orcesi, Simona</creatorcontrib><creatorcontrib>Parazzini, Cecilia</creatorcontrib><creatorcontrib>Chiapparini, Luisa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><jtitle>Neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tonduti, Davide</au><au>Pichiecchio, Anna</au><au>Uggetti, Carla</au><au>Bova, Stefania Maria</au><au>Orcesi, Simona</au><au>Parazzini, Cecilia</au><au>Chiapparini, Luisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How to look for intracranial calcification in children with neurological disorders: CT, MRI, or both of them?</atitle><jtitle>Neurological sciences</jtitle><stitle>Neurol Sci</stitle><addtitle>Neurol Sci</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>43</volume><issue>3</issue><spage>2043</spage><epage>2050</epage><pages>2043-2050</pages><issn>1590-1874</issn><eissn>1590-3478</eissn><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.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34383160</pmid><doi>10.1007/s10072-021-05510-w</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-9371-7454</orcidid></addata></record> |
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| subjects | Calcification Calcification (ectopic) Calcinosis - complications Calcinosis - diagnostic imaging Child Children Computed tomography Humans Magnetic resonance imaging Magnetic Resonance Imaging - methods Medical imaging Medicine Medicine & Public Health Nervous System Diseases - diagnostic imaging Nervous System Diseases - etiology Neuroimaging Neurological diseases Neurological disorders Neurology Neuroradiology Neurosciences Neurosurgery Original Article Patients Pediatrics Psychiatry Scanning Tomography, X-Ray Computed |
| title | How to look for intracranial calcification in children with neurological disorders: CT, MRI, or both of them? |
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