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Diagnostic Accuracy of Panoramic Radiography for Detecting Carotid Artery Calcification: An Ultrasonography-Validated Study
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Ladan Hafezi *   , Safa Moayedi |
| Oral and Maxillofacial Radiologist , lhafezzi@yahoo.com |
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Abstract: (9 Views) |
Background and Aim: Carotid artery calcification (CAC) is an important biomarker for cardiovascular risk prediction. This study aimed to assess the diagnostic accuracy of panoramic radiography in detecting carotid plaque compared with ultrasonography as the reference standard.
Materials and Methods: In this cross-sectional analytical study, panoramic radiographs of 120 patients (240 anatomic sides) were evaluated. Suspicious CAC opacities and their morphological patterns were recorded. All patients underwent carotid ultrasonography. Diagnostic performance indices were calculated on a side-based level, and the association between systemic risk factors and vascular involvement was analyzed at the patient level.
Results: Ultrasonography confirmed plaque in 51 sides (21.2%). Panoramic radiography yielded 19 true-positive, 33 false-positive, 32 false-negative, and 156 true-negative findings. Accordingly, sensitivity was 37.3%, specificity was 82.5%, positive predictive value was 36.5%, negative predictive value was 83.0%, and overall accuracy was 72.9%. Among panoramic patterns, the “vessel outlining” pattern showed the highest concordance with positive ultrasonographic findings. Age, diabetes, and other systemic risk factors were also significantly associated with vascular involvement.
Conclusion: Panoramic radiography is not an independent screening tool for CAC because of its low sensitivity and relatively high false-negative rate. However, due to its acceptable specificity, it may serve as an initial warning sign in dental settings. Positive incidental findings, particularly in patients with systemic risk factors, should be confirmed by carotid ultrasonography.
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| Keywords: Carotid Artery Calcifications, Radiography, Panoramic, Ultrasonography, Sensitivity and Specificity, Atherosclerosis, Diagnosis, Oral, Risk Factors. |
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Type of Study: original article |
Subject:
Radiology
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