Study of the localization of radiopacities similar to calcified carotid atheroma by means of panoramic radiography.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Kamikawa
Rosangela Saga
RS
Radiology Division, Stomatology Department, Dentistry School, University of São Paulo, São Paulo, Brazil. saysaga@brturbo.com.br
Pereira
Marlene Fenyo
MF
Fernandes
Angela
A
Meurer
Maria Inês
MI
D050197:Atherosclerosis / Q000000981:diagnostic imaging*; D002102:Cadaver; D002114:Calcinosis / Q000000981:diagnostic imaging*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D002342:Carotid Artery, External / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging*; D002356:Cartilage / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006801:Humans; D006928:Hyoid Bone / Q000000981:diagnostic imaging; D008022:Ligaments / Q000000981:diagnostic imaging; D009333:Neck / Q000000981:diagnostic imaging*; D011862:Radiography, Panoramic; D013961:Thyroid Gland / Q000000981:diagnostic imaging