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Cone-Beam CT Evaluation of Intracranial Physiological Calcifications by Age and Gender

Year 2025, Volume: 15 Issue: 1, 1 - 7, 28.03.2025
https://doi.org/10.33808/clinexphealthsci.1201994

Abstract

Objective: To assess the prevalence of physiological intracranial calcifications detected in cone-beam computed tomography (CBCT) images in a group of Turkish population by age and gender.
Methods: Full head CBCT images of 1000 patients (535 men, 465 women) with age range of 6-91 years were retrospectively analyzed. The presence of habenular, pineal gland, coroid plexus, petroclinoid ligament, interclinoid ligament, carotico-clinoid ligament, falx cerebri, tentorium cerebelli and basal ganglia calcifications were investigated by age groups and gender. Mann Whitney U test was used to calculate the calcification frequency by mean age and χ2 test was used for gender.
Results: CBCT examination of 1000 cases aged between 6 and 91 were evaluated in six groups respectively; ages under 19 (13.3%), age 20-29 (14.8%), age 30-39 (11.9%), age 40-49 (19.3%), age 50-59 (20.9%) ages over 60 (19.8%). Habenular calcification was the most common calcification with a rate of 69%. Only petroclinoid ligament calcification was significantly higher in men (p< .001). Statistically significant relationship was found between age groups and calcifications of habenular, pineal gland, choroid plexus, petroclinoid ligament, interclinoid ligament, caroticoclinoid ligament (p< .001).
Conclusion: Habenular calcification was the most common type of intracranial calcification in all age groups. As the probability of calcification increases with aging, an increase in the association of calcifications was observed. Physiological intracranial calcifications may be an incidental finding frequently encountered in CBCT examinations.

Ethical Statement

This retrospective study was approved by Ethical Committee of Gaziantep University (Protocol No:2020/387)

References

  • Daghighi M, Rezaei V, Zarrintan S, Pourfathi H. Intracranial physiological calcifications in adults on computed tomography in Tabriz, Iran. Folia Morphol. 2007;66(2):115–119.
  • Kieffer SA, Gold LH. Intracranial physiologic calcifications. Semin Roentgenol. 1974;9(2):151–162. https://doi.org/10.1016/0037-198x(74)90030-3
  • Dahnert WF. Radiology review manual. North American Edition, 2017.
  • William S. Radiology Review Manual. Philadelphia, PA: Lippincott Williams & Wilkins, 2003;5:230.
  • Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc. 2006;72(1):75–80.
  • Kwak R, Takeuchi F, Ito S, Kadoya S. Intracranial physiological calcification on computed tomography (Part 1): Calcification of the pineal region. No To Shinkei 1988;40(6):569–574.
  • Acer N, Ilıca AT, Turgut AT, Ozçelık O, Yıldırım B, Turgut M. Comparison of the three methods for the estimation of pineal gland volume using magnetic resonance imaging. Scientific World Journal 2012:123412. https://doi.org/10.1100/2012/123412
  • Hikosaka O, Sesack SR, Lecourtier L, Shepard PD. Habenula: crossroad between the basal ganglia and the limbic system. J Neurosci. 2008;28(46):11825–11829. https://doi.org/10.1523/JNEUROSCI.3463-08.2008
  • Marinescu I, Udristoiu I, Marinescu D. Choroid plexus calcification: clinical, neuroimaging and histopathological correlations in schizophrenia. Rom J Morphol Embryol. 2013;54(2):365–369.
  • Lang J. Wurzburg Skull Base and Related Structures. Atlas of Clinical Anatomy. J. Lang.− Stuttgart, 1995.
  • Wysiadecki G, Haladaj R, Polguj M, Zytkowski A. Bilateral extensive ossification of the posterior petroclinoid ligament: an anatomical case report and literature review. J Neurol Surg A Cent Eur Neurosurg. 2019;80(02):122–126. https://doi.org/10.1055/s-0038-1666782
  • Ozdogmus O, Saka E, Tulay C, Gurdal E, Uzun I, Cavdar S. Ossification of interclinoid ligament and its clinical significance. Neuroanatomy 2003;2(1):25–27.
  • Inoue T, Rhoton Jr AL, Theele D, Barry ME. Surgical approaches to the cavernous sinus: A microsurgical study. Neurosurgery 1990;26(6):903–932. https://doi.org/10.1097/00006123-199006000-00001
  • Shaikh SI, Ukey RK, Kawale DN, Diwan CV. Study of carotico-clinoid foramen in dry human skulls of Aurangabad district. Int J Basic Med Sci. 2012;3:148–154.
  • Deepak S, Jayakumar B. Extensive intracranial calcification. J Assoc Physicians India 2005;53:948.
  • Lowenthal A. Calcification of the striopallidodentate system. Handb Clin Neurol. 1968;6:703–725.
  • Sedghizadeh P, Nguyen M, Enciso R. Intracranial physiological calcifications evaluated with cone beam CT. Dentomaxillofac Radiol. 2012;41(8):675–678. https://doi.org/10.1259/dmfr/33077422
  • Bayrak S, Bulut DG, Çakmak ES, Orhan K. Cone Beam Computed Tomographic Evaluation of Intracranial Physiologic Calcifications. J Craniofac Surg. 2019;30(2):510–513. https://doi.org/10.1097/SCS.0000000000004918
  • Yalcin A, Ceylan M, Bayraktutan OF, Sonkaya AR, Yuce I. Age and gender related prevalence of intracranial calcifications in CT imaging; data from 12,000 healthy subjects. J Chem Neuroanat. 2016;78:20–24. https://doi.org/10.1016/j.jchemneu.2016.07.008
  • Orcan CG, Nas OF, Cavusoglu IG, Alan O, Kılıç H, Uyguc A, et al. The incidence and co-existence of physiological pineal gland, choroid plexus and habenular commissure calcifications detected in cranial computed tomography. Med Bull Sisli Etfal Hosp. 2010;44(1):22–26.
  • White SC, Pharoah MJ. Oral radiology-E-Book: Principles and interpretation: Elsevier Health Sciences, 2014.
  • Mutalik S, Tadinada A. Prevalence of pineal gland calcification as an incidental finding in patients referred for implant dental therapy. Imaging Sci Dent. 2017;47(3):175–180. https://doi.org/10.5624/isd.2017.47.3.175
  • Ozdede M, Kayadugun A, Ucok O, Altunkaynak B, Peker I. The assessment of maxillofacial soft tissue and intracranial calcifications via cone-beam computed tomography. Curr Med Imaging 2018;14(5):798–806. https://doi.org/10.2174/1573405613666170428160219
  • Whitehead MT, Oh C, Raju A, Choudhri AF. Physiologic pineal region, choroid plexus, and dural calcifications in the first decade of life. AJNR Am J Neuroradiol. 2015;36(3), 575-580. https://doi.org/10.3174/ajnr.A4153
  • Jassim MH, George NT, Jawad MM. Radiographic Anatomical Study of Intracranial Calcifications in Patients underwent Computerized Tomography Imaging. Int J Pharm Sci Med. 2019;4(2):1–13.
  • Cederberg RA, Benson BW, Nunn M, English JD. Calcification of the interclinoid and petroclinoid ligaments of sella turcica: a radiographic study of the prevalence. Orthod Craniofac Res. 2003;6(4):227–232. https://doi.org/10.1034/j.1600-0544.2003.00243.x
  • Turgut AT, Karakas HM, Ozsunar Y, ALtın L, Ceken K, Alıcıoglu B, et al. Age-related changes in the incidence of pineal gland calcification in Turkey: A prospective multicenter CT study. Pathophysiology 2008;15(1):41–48. https://doi.org/10.1016/j.pathophys.2008.02.001
  • Al-Ameri LT, Al-Zuhairi EA, Al-Shirwani HM. Prevalence of Pineal Gland and Choroid Plexus Calcification Among Iraqi Patients Attending CT Scan Units. Int J Morphol. 2021;39(1):244–251.
  • Uduma UF, Pius F, Mathieu M. Computed tomographic pattern of physiological intracranial calcifications in a city in central Africa. Glob J Health Sci. 2012;4(1):184–191. https://doi.org/10.5539/gjhs.v4n1p184
  • Dief S, Veitz-Keenan A, Amintavakoli N, McGowan R. A systematic review on incidental findings in cone beam computed tomography (CBCT) scans. Dentomaxillofac Radiol. 2019;48(7):20180396. https://doi.org/10.1259/dmfr.20180396
  • Bhuiyan PS, Rajgopal L, Shyamkishore K. Inderbir Singh's Textbook of Human Neuroanatomy: (Fundamental & Clinical). JP Medical Ltd. 2017.
  • Newton HB, Handbook of neuro-oncology neuroimaging. Academic Press, 2016.
  • Velasquez K, Molfese D, Salas R. The role of the habenula in drug addiction. Front Hum Neurosci. 2014;8:174. https://doi.org/10.3389/fnhum.2014.00174
  • Orrison WW. Atlas of brain function. Georg Thieme Verlag, Stuttgart, 2008.
  • Touska P, Hasso S, Oztek A, Chinaka F, Connor SE. Skull base ligamentous mineralisation: evaluation using computed tomography and a review of the clinical relevance. Insights Imaging 2019;10(1):1–17. https://doi.org/10.1186/s13244-019-0740-8
  • Skrzat J, Szewczyk R, Walocha J. The ossified interclinoid ligament. Folia Morphol. 2006; 65(3):242–245.
  • Erturk M, Kayalıoglu G, Govsa F. Anatomy of the clinoidal region with special emphasis on the caroticoclinoid foramen and interclinoid osseous bridge in a recent Turkish population. Neurosurg Rev. 2004;27(1):22–26. https://doi.org/10.1007/s10143-003-0265-x
  • Dorenbeck U, Leingärtner T, Bretschneider T, Krämer B, Feuerbachet S. Tentorial and dural calcification with tertiary hyperparathyroidism: A rare entity in chronic renal failure. Eur Radiol. 2002;12(3):11–13. https://doi.org/10.1007/s00330-002-1406-2
  • Koeppen AH. Merritt’s neurology: Edited by LP Rowland, Lippincott Williams & Wilkins, Philadelphia, 2000
  • Victor M, Ropper AH. Adams and Victor's principles of neurology. McGraw-Hill, Medical Pub. Division, 2001.
Year 2025, Volume: 15 Issue: 1, 1 - 7, 28.03.2025
https://doi.org/10.33808/clinexphealthsci.1201994

Abstract

References

  • Daghighi M, Rezaei V, Zarrintan S, Pourfathi H. Intracranial physiological calcifications in adults on computed tomography in Tabriz, Iran. Folia Morphol. 2007;66(2):115–119.
  • Kieffer SA, Gold LH. Intracranial physiologic calcifications. Semin Roentgenol. 1974;9(2):151–162. https://doi.org/10.1016/0037-198x(74)90030-3
  • Dahnert WF. Radiology review manual. North American Edition, 2017.
  • William S. Radiology Review Manual. Philadelphia, PA: Lippincott Williams & Wilkins, 2003;5:230.
  • Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc. 2006;72(1):75–80.
  • Kwak R, Takeuchi F, Ito S, Kadoya S. Intracranial physiological calcification on computed tomography (Part 1): Calcification of the pineal region. No To Shinkei 1988;40(6):569–574.
  • Acer N, Ilıca AT, Turgut AT, Ozçelık O, Yıldırım B, Turgut M. Comparison of the three methods for the estimation of pineal gland volume using magnetic resonance imaging. Scientific World Journal 2012:123412. https://doi.org/10.1100/2012/123412
  • Hikosaka O, Sesack SR, Lecourtier L, Shepard PD. Habenula: crossroad between the basal ganglia and the limbic system. J Neurosci. 2008;28(46):11825–11829. https://doi.org/10.1523/JNEUROSCI.3463-08.2008
  • Marinescu I, Udristoiu I, Marinescu D. Choroid plexus calcification: clinical, neuroimaging and histopathological correlations in schizophrenia. Rom J Morphol Embryol. 2013;54(2):365–369.
  • Lang J. Wurzburg Skull Base and Related Structures. Atlas of Clinical Anatomy. J. Lang.− Stuttgart, 1995.
  • Wysiadecki G, Haladaj R, Polguj M, Zytkowski A. Bilateral extensive ossification of the posterior petroclinoid ligament: an anatomical case report and literature review. J Neurol Surg A Cent Eur Neurosurg. 2019;80(02):122–126. https://doi.org/10.1055/s-0038-1666782
  • Ozdogmus O, Saka E, Tulay C, Gurdal E, Uzun I, Cavdar S. Ossification of interclinoid ligament and its clinical significance. Neuroanatomy 2003;2(1):25–27.
  • Inoue T, Rhoton Jr AL, Theele D, Barry ME. Surgical approaches to the cavernous sinus: A microsurgical study. Neurosurgery 1990;26(6):903–932. https://doi.org/10.1097/00006123-199006000-00001
  • Shaikh SI, Ukey RK, Kawale DN, Diwan CV. Study of carotico-clinoid foramen in dry human skulls of Aurangabad district. Int J Basic Med Sci. 2012;3:148–154.
  • Deepak S, Jayakumar B. Extensive intracranial calcification. J Assoc Physicians India 2005;53:948.
  • Lowenthal A. Calcification of the striopallidodentate system. Handb Clin Neurol. 1968;6:703–725.
  • Sedghizadeh P, Nguyen M, Enciso R. Intracranial physiological calcifications evaluated with cone beam CT. Dentomaxillofac Radiol. 2012;41(8):675–678. https://doi.org/10.1259/dmfr/33077422
  • Bayrak S, Bulut DG, Çakmak ES, Orhan K. Cone Beam Computed Tomographic Evaluation of Intracranial Physiologic Calcifications. J Craniofac Surg. 2019;30(2):510–513. https://doi.org/10.1097/SCS.0000000000004918
  • Yalcin A, Ceylan M, Bayraktutan OF, Sonkaya AR, Yuce I. Age and gender related prevalence of intracranial calcifications in CT imaging; data from 12,000 healthy subjects. J Chem Neuroanat. 2016;78:20–24. https://doi.org/10.1016/j.jchemneu.2016.07.008
  • Orcan CG, Nas OF, Cavusoglu IG, Alan O, Kılıç H, Uyguc A, et al. The incidence and co-existence of physiological pineal gland, choroid plexus and habenular commissure calcifications detected in cranial computed tomography. Med Bull Sisli Etfal Hosp. 2010;44(1):22–26.
  • White SC, Pharoah MJ. Oral radiology-E-Book: Principles and interpretation: Elsevier Health Sciences, 2014.
  • Mutalik S, Tadinada A. Prevalence of pineal gland calcification as an incidental finding in patients referred for implant dental therapy. Imaging Sci Dent. 2017;47(3):175–180. https://doi.org/10.5624/isd.2017.47.3.175
  • Ozdede M, Kayadugun A, Ucok O, Altunkaynak B, Peker I. The assessment of maxillofacial soft tissue and intracranial calcifications via cone-beam computed tomography. Curr Med Imaging 2018;14(5):798–806. https://doi.org/10.2174/1573405613666170428160219
  • Whitehead MT, Oh C, Raju A, Choudhri AF. Physiologic pineal region, choroid plexus, and dural calcifications in the first decade of life. AJNR Am J Neuroradiol. 2015;36(3), 575-580. https://doi.org/10.3174/ajnr.A4153
  • Jassim MH, George NT, Jawad MM. Radiographic Anatomical Study of Intracranial Calcifications in Patients underwent Computerized Tomography Imaging. Int J Pharm Sci Med. 2019;4(2):1–13.
  • Cederberg RA, Benson BW, Nunn M, English JD. Calcification of the interclinoid and petroclinoid ligaments of sella turcica: a radiographic study of the prevalence. Orthod Craniofac Res. 2003;6(4):227–232. https://doi.org/10.1034/j.1600-0544.2003.00243.x
  • Turgut AT, Karakas HM, Ozsunar Y, ALtın L, Ceken K, Alıcıoglu B, et al. Age-related changes in the incidence of pineal gland calcification in Turkey: A prospective multicenter CT study. Pathophysiology 2008;15(1):41–48. https://doi.org/10.1016/j.pathophys.2008.02.001
  • Al-Ameri LT, Al-Zuhairi EA, Al-Shirwani HM. Prevalence of Pineal Gland and Choroid Plexus Calcification Among Iraqi Patients Attending CT Scan Units. Int J Morphol. 2021;39(1):244–251.
  • Uduma UF, Pius F, Mathieu M. Computed tomographic pattern of physiological intracranial calcifications in a city in central Africa. Glob J Health Sci. 2012;4(1):184–191. https://doi.org/10.5539/gjhs.v4n1p184
  • Dief S, Veitz-Keenan A, Amintavakoli N, McGowan R. A systematic review on incidental findings in cone beam computed tomography (CBCT) scans. Dentomaxillofac Radiol. 2019;48(7):20180396. https://doi.org/10.1259/dmfr.20180396
  • Bhuiyan PS, Rajgopal L, Shyamkishore K. Inderbir Singh's Textbook of Human Neuroanatomy: (Fundamental & Clinical). JP Medical Ltd. 2017.
  • Newton HB, Handbook of neuro-oncology neuroimaging. Academic Press, 2016.
  • Velasquez K, Molfese D, Salas R. The role of the habenula in drug addiction. Front Hum Neurosci. 2014;8:174. https://doi.org/10.3389/fnhum.2014.00174
  • Orrison WW. Atlas of brain function. Georg Thieme Verlag, Stuttgart, 2008.
  • Touska P, Hasso S, Oztek A, Chinaka F, Connor SE. Skull base ligamentous mineralisation: evaluation using computed tomography and a review of the clinical relevance. Insights Imaging 2019;10(1):1–17. https://doi.org/10.1186/s13244-019-0740-8
  • Skrzat J, Szewczyk R, Walocha J. The ossified interclinoid ligament. Folia Morphol. 2006; 65(3):242–245.
  • Erturk M, Kayalıoglu G, Govsa F. Anatomy of the clinoidal region with special emphasis on the caroticoclinoid foramen and interclinoid osseous bridge in a recent Turkish population. Neurosurg Rev. 2004;27(1):22–26. https://doi.org/10.1007/s10143-003-0265-x
  • Dorenbeck U, Leingärtner T, Bretschneider T, Krämer B, Feuerbachet S. Tentorial and dural calcification with tertiary hyperparathyroidism: A rare entity in chronic renal failure. Eur Radiol. 2002;12(3):11–13. https://doi.org/10.1007/s00330-002-1406-2
  • Koeppen AH. Merritt’s neurology: Edited by LP Rowland, Lippincott Williams & Wilkins, Philadelphia, 2000
  • Victor M, Ropper AH. Adams and Victor's principles of neurology. McGraw-Hill, Medical Pub. Division, 2001.
There are 40 citations in total.

Details

Primary Language English
Subjects Oral and Maxillofacial Radiology
Journal Section Articles
Authors

Eda Didem Yalçın 0000-0001-8970-7579

Mehmet Emin Doğan 0000-0001-9660-9838

Early Pub Date March 23, 2025
Publication Date March 28, 2025
Submission Date November 9, 2022
Published in Issue Year 2025 Volume: 15 Issue: 1

Cite

APA Yalçın, E. D., & Doğan, M. E. (2025). Cone-Beam CT Evaluation of Intracranial Physiological Calcifications by Age and Gender. Clinical and Experimental Health Sciences, 15(1), 1-7. https://doi.org/10.33808/clinexphealthsci.1201994
AMA Yalçın ED, Doğan ME. Cone-Beam CT Evaluation of Intracranial Physiological Calcifications by Age and Gender. Clinical and Experimental Health Sciences. March 2025;15(1):1-7. doi:10.33808/clinexphealthsci.1201994
Chicago Yalçın, Eda Didem, and Mehmet Emin Doğan. “Cone-Beam CT Evaluation of Intracranial Physiological Calcifications by Age and Gender”. Clinical and Experimental Health Sciences 15, no. 1 (March 2025): 1-7. https://doi.org/10.33808/clinexphealthsci.1201994.
EndNote Yalçın ED, Doğan ME (March 1, 2025) Cone-Beam CT Evaluation of Intracranial Physiological Calcifications by Age and Gender. Clinical and Experimental Health Sciences 15 1 1–7.
IEEE E. D. Yalçın and M. E. Doğan, “Cone-Beam CT Evaluation of Intracranial Physiological Calcifications by Age and Gender”, Clinical and Experimental Health Sciences, vol. 15, no. 1, pp. 1–7, 2025, doi: 10.33808/clinexphealthsci.1201994.
ISNAD Yalçın, Eda Didem - Doğan, Mehmet Emin. “Cone-Beam CT Evaluation of Intracranial Physiological Calcifications by Age and Gender”. Clinical and Experimental Health Sciences 15/1 (March 2025), 1-7. https://doi.org/10.33808/clinexphealthsci.1201994.
JAMA Yalçın ED, Doğan ME. Cone-Beam CT Evaluation of Intracranial Physiological Calcifications by Age and Gender. Clinical and Experimental Health Sciences. 2025;15:1–7.
MLA Yalçın, Eda Didem and Mehmet Emin Doğan. “Cone-Beam CT Evaluation of Intracranial Physiological Calcifications by Age and Gender”. Clinical and Experimental Health Sciences, vol. 15, no. 1, 2025, pp. 1-7, doi:10.33808/clinexphealthsci.1201994.
Vancouver Yalçın ED, Doğan ME. Cone-Beam CT Evaluation of Intracranial Physiological Calcifications by Age and Gender. Clinical and Experimental Health Sciences. 2025;15(1):1-7.

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