Özkan Gökhan, Köse Emre, Yeşiltepe Selin
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey.
J Ultrasound Med. 2023 May;42(5):1057-1064. doi: 10.1002/jum.16117. Epub 2022 Oct 27.
The aim of this study is to present a comparison between panoramic radiographs and USG imaging with a focus on revealing the advantages of USG over radiographs, and to show the distribution of calcifications detected in USG by considering the age and gender.
A total of 148 patients with soft tissue calcifications as seen on panoramic radiographs were examined with USG imaging. Sialoliths, carotid artery calcifications, tonsilloliths, phleboliths and lymph node calcifications were examined in terms of anatomical localization, distribution and shape.
In the USG evaluation of these 148 patients, soft tissue calcifications were observed in 113 (76.4%) patients. The mean age of the patients with calcification was 55.6 ± 13.1 (min: 22-max: 77). Bilateral calcifications were detected in 25 (22.1%) patients, whereas unilateral calcifications were found in 88 (77.9%) patients. While the rates of tonsilloliths, sialoliths, phleboliths, and lymph node calcifications were statistically similar in male and female patients, the rate of carotid artery calcifications was found to be higher in men than in women (P = 0.017). No statistical significance was found between age groups in terms of the formation of soft tissue calcifications (P = 0.117).
Panoramic radiographs may mislead clinicians in the diagnosis and differential diagnosis of soft tissue calcifications in the head and neck region due to the presence of distortion, superpositions, metal artefacts, and ghost images. USG is an important diagnostic tool in determining the localization of soft tissue calcifications that can be confused on two-dimensional radiographs, their relationship with neighboring structures, and defining calcification. It can be used safely in the detection of soft tissue calcifications as it provides dynamic imaging without the use of radiation or contrast material compared to other advanced imaging methods.
本研究旨在比较全景X线片和超声成像，重点揭示超声相对于X线片的优势，并按年龄和性别展示超声检查中发现的钙化分布情况。
对148例全景X线片显示有软组织钙化的患者进行超声成像检查。从解剖定位、分布和形态方面检查涎石、颈动脉钙化、扁桃体结石、静脉石和淋巴结钙化。
在对这148例患者的超声评估中，113例（76.4%）患者观察到软组织钙化。钙化患者的平均年龄为55.6±13.1岁（最小：22岁 - 最大：77岁）。25例（22.1%）患者检测到双侧钙化，而88例（77.9%）患者为单侧钙化。男性和女性患者中扁桃体结石、涎石、静脉石和淋巴结钙化的发生率在统计学上相似，但发现男性颈动脉钙化的发生率高于女性（P = 0.017）。在软组织钙化形成方面，各年龄组之间未发现统计学差异（P = 0.117）。
由于存在变形、叠加、金属伪影和重影，全景X线片在头颈部软组织钙化的诊断和鉴别诊断中可能会误导临床医生。超声是确定二维X线片上可能混淆的软组织钙化的定位、其与相邻结构的关系以及定义钙化的重要诊断工具。与其他先进成像方法相比，超声无需使用辐射或造影剂即可提供动态成像，因此可安全用于软组织钙化的检测。
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