Livingston John H, Stivaros Stavros, Warren Dan, Crow Yanick J
Department of Paediatric Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Dev Med Child Neurol. 2014 Jul;56(7):612-26. doi: 10.1111/dmcn.12359. Epub 2013 Dec 30.
Intracranial calcification (ICC) is a common finding on neuroimaging in paediatric neurology practice. In approximately half of all cases the calcification occurs in damaged, neoplastic, or malformed brain. For the large number of other disorders in which ICC occurs, no common pathogenetic mechanism can be suggested. Congenital infection, particularly with cytomegalovirus, accounts for a significant proportion of all cases. However, some genetic diseases, in particular Aicardi-Goutières syndrome, Band-like calcification, and RNASET2-related disease, may mimic congenital infection; therefore, a full consideration of the radiological and clinical features is necessary before concluding that congenital infection is the cause. In some disorders calcification is a universal finding, in others it is a frequent occurrence, and in some it is only an occasional finding. Characteristic patterns of calcification are seen in a number of conditions, and a systematic approach to the identification and description of radiological findings, taken together in the context of the clinical scenario, allows a diagnosis to be made in many cases. Nonetheless, there remain a number of presumed genetic disorders associated with ICC for which the underlying molecular cause has not yet been identified.
颅内钙化(ICC)是儿科神经病学实践中神经影像学检查常见的表现。在所有病例中,约半数钙化发生于受损、肿瘤性或畸形的脑部。对于大量出现ICC的其他疾病,尚无共同的发病机制。先天性感染,尤其是巨细胞病毒感染,在所有病例中占相当比例。然而,一些遗传性疾病,特别是Aicardi-Goutières综合征、带状钙化和RNASET2相关疾病,可能酷似先天性感染;因此,在认定先天性感染为病因之前,有必要全面考虑影像学和临床特征。在某些疾病中钙化是普遍现象,在另一些疾病中钙化很常见,而在某些疾病中钙化只是偶尔出现。在多种情况下可观察到特征性的钙化模式,结合临床情况,采用系统方法识别和描述影像学表现,在许多病例中可做出诊断。尽管如此,仍有一些与ICC相关的推测性遗传性疾病,其潜在分子病因尚未明确。