E2750. Got Calcium? A Review of Calcification Patterns on Abdominal Radiographs
Authors
Faizullah Mashriqi;
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health
John Hines;
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health
Background
Calcifications are a salient manifestation of both benign and malignant intra-abdominal processes. Understanding patterns of abdominal calcifications in certain anatomical distributions can aid in guiding the diagnostic radiologist in forming a differential diagnosis. Generally, tissue calcifications occur in one of four settings; dystrophic calcification occurs in the setting of cellular injury in a normal background blood calcium level. Metastatic calcifications occur in the setting of hypercalcemia resulting in calcium precipitation in otherwise normal tissue. When there is stasis of content in hollow viscera, stasis to flow-type calcifications can occur. Lastly, tumor calcifications occur in the setting of necrotic or mucinous neoplasms.
Educational Goals / Teaching Points
This educational exhibit aims to discuss mechanisms of intra-abdominal calcifications; discuss four basic types of calcification morphology; review differential diagnosis for intra-abdominal and intrapelvic calcifications; and demonstrate examples of vascular, gastrointestinal, genitourinary and other abdominal calcifications, with CT correlation in appropriate cases.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Classically intra-abdominal calcifications occur in one of four morphologies. Concretions represent discrete calcified deposits and can be seen in urinary tract stones, gallstones, pancreatic calcifications, phleboliths, appendicoliths, etc. Conduit calcifications occur in the wall of a tube-like structure. This can be seen in arteries, ductus deferens, pancreatic duct and other fluid filled tubular structures. Curvilinear densities are characteristic for cystic calcifications and represent a calcified rim of a lesion. This can be seen in simple cysts, aneurysms, porcelain gallbladder and echinococcal cysts. Solid mass calcifications can have a broad morphologic appearance. These are often seen with uterine leiomyomas, but can be seen with metastases, primary neoplasms (for example mucinous GI tract tumors), tuberculosis, and auto-splenectomy.
Conclusion
Intra-abdominal calcifications are a key diagnostic clue on abdominal radiographs. Localizing the anatomic compartment and identifying the calcification morphology can aid in forming a differential diagnosis.
