Correlating carotid artery stenosis detected by panoramic radiography with clinically relevant carotid artery stenosis determined by duplex ultrasound

Dov M. Almog, Tuvia Horev, Karl A. Illig, Richard M. Green, Laurie C. Carter

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

Objective. We sought to assess the utility of panoramic radiography as an adjunct screening tool for detecting significant asymptomatic carotid artery stenosis. The specific aim was to correlate calcifications seen in the region of the carotid bifurcation with clinically relevant carotid artery stenosis as determined by duplex ultrasound (DUS). Study design. Routine dental panoramic films of patients 55 and older (n = 778) at the University of Rochester Eastman Dental Center were retrospectively reviewed for calcifications around the carotid bifurcation. Patients with such calcifications were referred for DUS, and raw data were interpreted by a vascular surgeon blinded to the radiographic findings. Groups were compared by using the χ2 test. Results. Twenty-seven patients (3.5%) had suggestive radiographic calcifications on one or both sides, 20 of whom consented to DUS. Clinically significant carotid stenoses (>50% lumenal narrowing) were present in 50% of the sides with calcification compared with 21% of the sides without (P = .08, χ2). Three patients (15% of those screened with DUS) had stenoses greater than 80% and underwent 4 carotid endarterectomies as a direct result of screening. Conclusions. Data suggest that clinically significant stenosis may exist if calcifications are observed on panoramic radiographs. Incidental examination of this area carries a minimal cost and appears beneficial as a screening tool for carotid disease, although definitive testing must follow.

Original languageEnglish
Pages (from-to)768-773
Number of pages6
JournalOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
Volume94
Issue number6
DOIs
StatePublished - 1 Jan 2002
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology
  • General Dentistry

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