Digital panoramic radiography: a reliable method to diagnose carotid artery atheromas?

The aim of the present study is to evaluate the panoramic radiographs of 4106 patients for carotid artery atheromas (CAAs) and to correlate our findings with the literature.

The digital panoramic radiographs of 4106 dental patients (2428 female, 1678 male) were evaluated. Radiographs of patients 40 years of age or older were randomly chosen from a computer database. CAA findings were defined as radiopaque masses adjacent to the cervical vertebrae at or below the intervertebral space between C3 and C4 on the panoramic radiograph. The patients who had CAA findings were contacted by telephone, and some of them agreed to further evaluation. Evaluation included carotid ultrasound, ECG, echocardiography and treadmill exercise testing at the Department of Cardiology.

Of 4106 patients, 88 patients (2.1%; 70 female, 18 male) had one or more radiopaque mass detected on digital images. All 88 patients with CAA findings were contacted by telephone and 23 agreed to further evaluation at the university hospital. Of these 23 patients, 8 (34.7%) had CAAs on carotid ultrasound and 15 (65.3%) had normal carotid arteries. From these eight patients with CAAs on Doppler ultrasound, 7 (30.4%) had plaques that were not haemodynamically significant and only one (4.3%) had significant plaque. The patient with severe carotid artery stenosis consequently underwent endarterectomy operation. There were no statistically significant differences between male and female in CAAs (P>0.05).

Digital panoramic images may have some diagnostic value for detecting CAAs and this early diagnosis could potentially increase the length and quality of life for people with CAAs.