Kamikawa Rosangela Saga, Pereira Marlene Fenyo, Fernandes Angela, Meurer Maria Inês
Radiology Division, Stomatology Department, Dentistry School, University of São Paulo, São Paulo, Brazil.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):374-8. doi: 10.1016/j.tripleo.2005.03.030.
To determine the location in soft tissues of the calcifications, similar to calcified carotid atheromas, that can be observed radiographically in the cervical region in panoramic radiographs.
In each anatomic cadaver specimen preserved in formol, consisting of the head and neck, radiopaque spheres (made from gutta-percha) were positioned in anatomic structures of the cervical region that can be sites of calcification. For each anatomic structure marked in this way, panoramic radiography was performed, consisting of 17 radiographs. The images obtained were analyzed by 24 examiners who indicated which radiographs, in their opinion, presented the radiopaque reference projected in the region of bifurcation of the carotid artery. Analysis of 2 proportions from agreement and disagreement was used to determine radiopacities that could be confused in panoramic radiographs with calcified atheromas in the carotid artery.
The results showed that 75% (18) of the examiners correctly indicated the reference in the bifurcation of the carotid artery and 79.2% (19) indicated a triticeous cartilage as calcified atheroma of the carotid artery.
Calcified atheromas of the carotid artery are not the only features that can produce radiopaque images lateral to the panoramic radiograph; the presence of calcification in the triticeous cartilage also can induce an erroneous diagnosis of calcified carotid atheroma.
确定在全景X线片上可在颈部区域观察到的类似于钙化颈动脉粥样硬化斑块的钙化在软组织中的位置。
在每个用福尔马林保存的包括头颈部的解剖尸体标本中，将不透射线球体（由牙胶制成）放置在颈部区域可能发生钙化的解剖结构中。对于以此方式标记的每个解剖结构，进行全景X线摄影，共拍摄17张X线片。由24名检查者对获得的图像进行分析，他们指出在他们看来哪些X线片显示了不透射线参照物投影在颈动脉分叉区域。采用一致性和不一致性的两个比例分析来确定在全景X线片中可能与颈动脉钙化粥样硬化斑块混淆的不透射线影像。
结果显示，75%（18名）检查者正确指出了颈动脉分叉处的参照物，79.2%（19名）检查者将麦粒软骨误判为颈动脉钙化粥样硬化斑块。
颈动脉钙化粥样硬化斑块不是全景X线片外侧产生不透射线影像的唯一特征；麦粒软骨中的钙化也可导致对颈动脉钙化粥样硬化斑块的误诊。
