Mineralizing microangiopathy is a condition characterized by parenchymal cerebral calcifications and is usually seen in children as a complication of cranial radiotherapy and chemotherapy .
Mineralizing microangiopathy can affect the brain widely, with typical sites involved including :
- 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
- 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
- Sturge-Weber syndrome
- calcification is leptomeningeal/cortical rather than subcortical
Causes of basal ganglia calcification are discussed separately.