Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden.
Department of Clinical Sciences, Lund University, Malmö, Sweden.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2024 Apr;137(4):408-420. doi: 10.1016/j.oooo.2023.12.783. Epub 2023 Dec 26.
The aim was to optimize diagnostics for carotid artery calcifications (CACs) on panoramic radiographs (PRs) to identify cardiovascular disease (CVD) by investigating how 4 defined CAC shapes are associated with ultrasound (US) findings indicating CVD.
The study included 414 participants (802 neck sides) from the Malmö Offspring Dental Study, examined with PRs. The PRs were assessed for CAC shapes stratified into 4 categories: single, scattered, vessel-width defining, and vessel-outlining. The carotid arteries were examined with US for signs of CVD: the presence of plaques, largest individual area of a plaque, number of plaques, and percentage reduction of the lumen. Associations between the different CAC categories and US characteristics were analyzed.
All categories of CAC were significantly associated with a higher degree of US findings indicating CVD compared with no CAC (P < .001). The most significant differences were found for vessel-outlining CAC, with the mean of the largest individual plaque area of 17.9 vs 2.3 mm, mean number of plaques 1.6 vs 0.2, and mean percentage reduction of the lumen 24.1% vs 3.5% (all P < .001).
Independent of shape, CACs detected on PRs were associated with a higher degree of US findings of CVD. This was most pronounced for vessel-outlining CAC. With refined differential diagnostics of CACs in PRs, dentists may contribute to improved identification of patients in need of cardiovascular prevention.
通过研究 4 种定义明确的 CAC 形状与超声(US)检查提示心血管疾病(CVD)的结果之间的关系,优化全景片(PR)上颈动脉钙化(CAC)的诊断,以识别心血管疾病。
该研究纳入了来自马尔默后代牙科研究的 414 名参与者(802 个颈部侧位),这些参与者接受了 PR 检查。将 PR 上的 CAC 形状分为 4 类进行评估:单发、散在、血管宽度定义型和血管轮廓型。使用 US 检查颈动脉是否存在 CVD 迹象:斑块的存在、斑块的最大单个面积、斑块数量和管腔缩小百分比。分析不同 CAC 类别与 US 特征之间的关联。
与无 CAC 相比,所有 CAC 类别与 US 提示 CVD 的程度较高均具有显著相关性(P<.001)。与其他类别相比,血管轮廓型 CAC 的差异最为显著,最大单个斑块面积的平均值为 17.9 毫米对 2.3 毫米,斑块数量的平均值为 1.6 个对 0.2 个,管腔缩小百分比的平均值为 24.1%对 3.5%(均 P<.001)。
PR 上检测到的 CAC 与 US 提示 CVD 的程度较高有关,与形状无关。血管轮廓型 CAC 最为明显。通过对 PR 上的 CAC 进行精细化的鉴别诊断,牙医可能有助于更准确地识别需要心血管预防的患者。