Panoramic Radiography and Cone Beam Computed Tomography in the Early Diagnosis of Atheroma in the Extracranial and Intracranial Internal Carotid Artery: A Case Report

Abstract

Carotid stenosis usually results from the accumulation of atherosclerotic plaque in the carotid artery wall and is an important risk factor for ischemic cerebral vascular accident (CVA). This study describes the importance of diagnostic imaging exams used in dentistry for the early identification of atheroma plaques in the extracranial and intracranial internal carotid artery. A male patient was referred to a radiology clinic to perform panoramic radiography (PR) and a cone beam computed tomography (CBCT) to develop treatment plan options. In the PR and CBCT a radiopaque image, suggestive of atheroma in the extracranial internal carotid artery, was observed on the right side. The diagnosis was confirmed by color DOPPLER ultrasonography. In the CBCT, the presence of calcifications in the intracranial internal carotid artery was also observed. Diagnostic imaging exams used in dentistry allow the identification of asymptomatic individuals, facilitating early intervention and consequent reduction in the risk of ischemic CVA.

Potential of Routine X-ray Examinations in Detecting Signs of Asymptomatic Carotid Disease

“…The obtained findings are consistent with the data of foreign researchers. (26)(27)(28)(29)(30) Thus, carotid artery calcifications suggest the presence of atherosclerosis of the particular localization and consequently the presence of high risk for developing ischemic stroke; hence, the above-mentioned techniques (DPR, CSR, CBCT, MSCT) have to be used as an instrument for detecting a predictor of this socially and economically significant pathological condition of the cardiovascular system.…”

Diagnóstico de Ateroma de Carótidas por Meio de Radiografia Panorâmica: Série de Casos

“…A radiografia panorâmica é o exame por imagem frequentemente utilizado na rotina odontológica, com o objetivo de observar a dentição e diagnosticar patologias maxilares. 5,6 Dessa forma, a radiografia panorâmica, apresenta papel importante na detecção de ateroma, revelando-se uma massa radiopaca no espaço intervertebral entre C3 e C4, acima ou abaixo do osso hióide 3,[6][7][8] . Entretanto, apenas a radiografia panorâmica não possibilita avaliar o grau de obstrução e nem a localização exata da lesão, sendo assim, é necessário a realização de outros exames, como a ultrassonografia com Doppler, que possibilita a correta localização do ateroma, bem como seu tamanho na carótida 1 .…”