Physiological Intracranial Calcifications in Children: A computed tomography-based study

OBJECTIVES: This study aimed to examined the frequency of physiological intracranial calcifications (PICs) in paediatric population using computed tomography (CT). METHODS: The brain CT scans of consecutive patients (age range: 0–15 years) who had visited Sultan Qaboos University Hospital, Muscat, Oman, from January 2017 to December 2020 were retrospectively assessed for the presence of PICs. The presence of calcifications was identified using 3 mm-thick axial images and coronal and sagittal reformats. RESULTS: A total of 460 patients were examined, with a mean age of 6.54 ± 4.94 years. The frequency of PIC in boys and girls was 35.1% and 35.4%, respectively. PICs were most common in choroid plexus, observed in 35.2% (age range: 0.4–15 years, median: 12 years) of subjects, followed by the pineal gland in 21.1% (age range: 0.5–15 years, median: 12 years) and the habenular nucleus in 13.0% of subjects (age range: 2.9–15 years; median: 12 years). PICs were less common in falx cerebri, observed in 5.9% (age range: 2.8–15 years; median: 13 years) of subjects, and tentorium cerebelli, observed in 3.0% (age range: 7–15 years, median: 14 years) of subjects. PICs increased significantly with increase in age (P <0.001). CONCLUSION: Choroid plexus is the most frequent site of calcification. Choroid plexus and pineal gland calcifications may be present in infants younger than one year. Recognising PICs is clinically important for radiologists as they can be mistaken for haemorrhage or pathological entities such as neoplasms or metabolic diseases.