Mineralizing microangiopathy: CT and MRI

Abstract

Mineralizing microangiopathy, a distinctive histopathologic process involving the microvasculature of the central nervous system (CNS), is usually seen following combined radiation and chemotherapy for the treatment of CNS neoplasms in childhood. CT typically demonstrates calcification within the basal ganglia and subcortical white matter. The areas of calcification may give paradoxically increased signal on T1-weighted MRI due to a surface-relaxation mechanism, and decreased signal on T2-weighted images.

Micro-imaging of Brain Cancer Radiation Therapy Using Phase-contrast Computed Tomography

“…Again the methods all afford similar morphological results and complement each other in terms of functional information. The presence of calcium and iron accumulation within degenerating cancerous tissues, either radiationinduced, as already reported in literature [70][71][72] , or from intra-tumor calcification or blood extravasation, leads to very intense bright signals in PCI. We can conclude that highly dense materials (such as iron and calcium) strongly affect PCI imaging and could be involved in the formation of the PCI signal hyper-intensities observed within vasculature (from iron-rich blood aggregates) or within GBM tissues (again from the high blood volumes likely present).…”

A Cross-Sectional Cohort Study of Cerebrovascular Disease and Late Effects After Radiation Therapy for Craniopharyngioma

“…One patient in our study was suspected to have either a cavernous malformation or remote focus of hemorrhage in the left periventricular white matter. Lastly, small vessel vasculopathy has been demonstrated from cranial irradiation . In an autopsy study of 163 children treated with cranial RT, 17% had mineralizing microangiopathy (a process affecting small‐caliber vessels that leads to calcification of the basal ganglia) .…”

Neuroimaging in Pediatric Leukemia and Lymphoma: Differential Diagnosis

“…Nowadays, with the more conservative protocols, a subtle pattern can be discovered on follow-up MR images, with putaminal increased signal intensity on T1-weighted images due to a surface-relaxation mechanism and decreased signal intensity on T2-weighted images (Fig 9). These imaging findings appear 2 or more years after the cranial irradiation, are more common with combined chemotherapy (especially intrathecal) and radiation therapy, and do not clearly correlate with clinical symptoms (16).…”