ORIGINAL ARTICLE Incidental internal carotid artery calcifications on temporal bone CT in children Bernadette Koch & Aaron Blackham & Blaise Jones Received: 30 June 2006 / Revised: 6 October 2006 / Accepted: 12 October 2006 / Published online: 21 November 2006 # Springer-Verlag 2006 Abstract Background Incidental internal carotid artery (ICA) calci- fications are occasionally noted on CT images of the brain and temporal bone. In adults, incidental calcifications have been correlated with increased incidence of hypercholester- olemia, cardiac disease, diabetes and carotid stenosis. Objective To determine the incidence of incidental calcifi- cations of the carotid siphon on temporal bone CT in children. Materials and methods We retrospectively reviewed 24 months of consecutive temporal bone CT examinations in children aged 18 years and younger. CT examinations on 663 patients were reviewed and the presence or absence of ICA calcifications was ranked as absent, questionable or definitive. In patients in whom definitive calcifications were identified, hospital charts were reviewed for evidence of diabetes mellitus, hypercholesterolemia, hypertriglycer- idemia, hyperlipidemia and chronic renal disease as potential causes of early atherosclerosis. Results Of the 663 patients, 25% had definitive calcifica- tions within the wall of the ICA: 6% of children younger than 2 years and 28% of children 12–19 years of age. Conclusions Incidentally noted ICA calcifications are a common finding on temporal bone CT in children, most likely a physiologic response to turbulent flow at natural bends in the artery rather than secondary to underlying disease predisposing to early atherosclerotic calcification. Keywords Carotid calcification . Temporal bone . Children Introduction Incidental arterial calcifications identified on conventional radiographs [1] and CT images [2–4] have received much attention because of their potential predictive value for atherosclerotic disease, hypercholesterolemia, diabetes, car- diac disease, carotid arterial stenosis and stroke. Although these associations have been reported in adults [2, 5], the incidence of incidental carotid arterial calcifications in children has not been reported. Anecdotally, we have noted an occasional carotid arterial calcification in the region of the cavernous internal carotid artery on routine CT examinations of the head and temporal bone in children imaged for reasons other than stroke. The purpose of this study was to identify the incidence of incidental carotid siphon calcifications on CT images of the temporal bone in children younger than 19 years. In addition, we sought to correlate these findings with additional risk factors of premature atherosclerotic disease such as hypercholesterol- emia, diabetes and renal disease. Material and methods This study was performed after IRB approval. The imaged portions of the carotid arteries were retrospectively evalu- ated for signs of calcifications on 726 consecutive axial non- contrast CT examinations of the temporal bone in children between April 2002 and April 2004. During the study Pediatr Radiol (2007) 37:141–144 DOI 10.1007/s00247-006-0355-3 B. Koch (*) : B. Jones Department of Radiology, Cincinnati Children’ s Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229, USA e-mail: Bernadette.Koch@cchmc.org A. Blackham University of Cincinnati College of Medicine, Cincinnati, OH, USA