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Identification of mineral deposits in the brain on radiological images: a systematic review

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Abstract

Objectives

MRI has allowed the study of mineral deposition in the brain throughout life and in disease. However, studies differ in their reporting of minerals on MRI for reasons that are unclear.

Methods

We conducted a systematic review from 1985 to July 2011 to determine the appearance of iron, calcium, copper and manganese on MRI and CT and their reliability. We assessed which imaging investigations provided the most consistent results compared with histology.

Results

Of 325 papers on minerals imaging, we included 46 studies that confirmed findings either directly or indirectly using a non-imaging method such as histology. Within this group, there was inconsistency in the identification of iron probably because of changes in its paramagnetic properties during its degradation. Iron appeared consistently hypointense only on T2*-weighted MRI, and along with calcified areas, hyperattenuated on CT. Appearance of copper, calcium and manganese, although consistently reported as hyperintense on T1-weighted MRI, was confirmed histologically in few studies. On T2-weighted imaging, calcified areas were always reported as hypointense, while the appearance of iron depended on the concentration, location and degradation stage.

Conclusions

More work is required to improve the reliability of imaging methods to detect and differentiate brain mineral deposition accurately.

Key Points

• There is inconsistency in reporting the appearance of minerals on radiological images.

• Only 46 studies confirmed mineral appearance using a non-imaging method.

• Iron is the mineral more widely studied, consistently hypointense on T2*-weighted MRI.

• T1-weighted MRI consistently reported copper, calcium and manganese hyperintense.

• Calcium is consistently reported hypointense on T2-weighted MRI and hyperattenuating on CT.

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Acknowledgements

L.C.M. and E.M.J.T. are funded by The University of Edinburgh College of Medicine Vacation Scholarship, M.C.V.H. is funded by Row Fogo Charitable Trust and J.M.W. is partially funded by the SINAPSE (Scottish Imaging Network A Platform for Scientific Excellence) collaboration.

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Author notes

  1. Elizabeth M. J. Tan

    Present address: Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Authors and Affiliations

  1. Brain Research Imaging Centre, Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK

    Maria del C. Valdés Hernández & Joanna M. Wardlaw

  2. Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK

    Maria del C. Valdés Hernández & Joanna M. Wardlaw

  3. SINAPSE (Scottish Imaging Network, A Platform for Scientific Excellence) collaboration, Edinburgh, Scotland, UK

    Maria del C. Valdés Hernández & Joanna M. Wardlaw

  4. College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK

    Lucy C. Maconick & Elizabeth M. J. Tan

  5. Brain Research Imaging Centre, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK

    Maria del C. Valdés Hernández

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  1. Maria del C. Valdés Hernández
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Correspondence to Maria del C. Valdés Hernández.

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del C. Valdés Hernández, M., Maconick, L.C., Tan, E.M.J. et al. Identification of mineral deposits in the brain on radiological images: a systematic review. Eur Radiol 22, 2371–2381 (2012). https://doi.org/10.1007/s00330-012-2494-2

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