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Pineal calcification refers to calcium deposition within the pineal gland, commonly seen as a physiologic (normal) finding on CT.

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Epidemiology

Seen in ~50–70% of adults
Rare in children <10 years
Incidence increases with age
Slight male predominance

Physiology

Pineal gland undergoes physiologic calcification (corpora arenacea / “brain sand”)
Composed of:
- Calcium phosphate/carbonate
No functional impairment in most cases

Radiology

Imaging Features:

Modality	Imaging features
CT	• Hyperdense midline focus posterior to 3rd ventricle
• Typical patterns: Punctate, globular or confluent
• Usually central and symmetric
MR	• Variable signal (depends on calcium): Often T1/T2 hypointense with blooming on GRE/SWI
• Less sensitive than CT

Differentials

Normal vs Abnormal Pineal Calcification:

Feature	Physiological	Pathological
Age	>10 years	<10 years
Size	Small (<1 cm)	Large or irregular calcification
Location	Midline and symmetric	Eccentric/displaced calcification
Associations	None	Soft tissue mass, hydrocephalus