Comparison of panoramic radiography in detection of carotid artery calcifications with Doppler Sonography results

Background: One of the important findings in panoramic radiology is the detection of a calcified plaque in the carotid artery therefore the dentist may be the first health care practitioner to detect a life-threatening illness. Objective: The aim of the present study was to compare the diagnostic accuracy of the panoramic radiographs with Doppler ultrasound for detection of carotid artery calcification in patient with end stage disease. Methods: Thirty-eight adult patients with renal disease were referred for Doppler ultrasound examination for the detection of carotid artery calcification. Later, the panoramic radiographs of these patients were evaluated by two radiologists for the detection of calcification around the carotid bifurcation. Data of panoramic radiography and Doppler ultrasound were analyzed by SPSS using Cohen kappa analysis and chi-squared test. Findings: Accuracy, sensitivity, and the specificity of panoramic radiographs were 75.6%, 70.1%, and 77.2%, respectively. There was a significant difference between the panoramic radiology and Doppler ultrasound results with moderate agreement (p>0.05, k=0.490). Inter observer reliability in panoramic technique was shown to be excellent (kappa=0.890). Conclusion: All panoramic radiographs made for evaluation of oral structures, should be carefully screened for detection of carotid artery calcification, particularly radiographs of high risk patients.