Radiation-induced brain calcification: paradoxical high signal intensity in T1-weighted MR images

Acta Neurochir (Wien). 2000;142(7):801-4. doi: 10.1007/s007010070095.

Abstract

Background: Irradiation to the central nervous system (CNS) in childhood is known to induce cerebral calcification after a latent period. Calcification has been generally found to show nil or a reduction in signal intensity in magnetic resonance (MR) images. However, we have studied three patients with radiation-induced brain calcification, who manifested increased signal intensity on T1-weighted MR images.

Method: Three girls had each been diagnosed as having a suprasellar germ cell tumour and were treated with conventional fractionated radiotherapy in their childhood. In one case, chemotherapy was given prior to the CNS irradiation.

Findings: All three patients survived their disease, and a follow-up CT scan revealed calcification in the brain, which has shown an increased signal intensity in the T1-weighted images of MR.

Interpretation: Cerebral calcification may be presented as a high signal intensity in the T1-weighted MR images. This may be explained by a surface-relaxation effect by the calcium salt particle, precipitated in the brain due to radiation-induced mineralising microangiopathy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Brain Diseases / etiology*
  • Brain Neoplasms / radiotherapy*
  • Calcinosis / etiology*
  • Cerebrovascular Disorders / etiology
  • Child
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Neoplasms, Germ Cell and Embryonal / radiotherapy*
  • Radiation Injuries / etiology*
  • Radiotherapy / adverse effects*