Vrijednost nalaza kalcifikacija u projekciji karotidnih arterija na ortopantomogramu u otkrivanju stenoze karotidnih arterija

doctoral thesis

• Title (english): Significance of calcifications in the projection of carotid arteries on orthopantomography for detection of carotid artery stenosis
• Author: Mia Smoljan Basuga
• Mentor: Dijana Zadravec (mentor)
• Committee member: Vanja Bašić Kes (predsjednik povjerenstva)
• Committee member: Tomislav Badel (član povjerenstva)
• Committee member: Jelena Popić (član povjerenstva)
• Committee member: Ivan Puhar (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Chair of General and Dental Radiology); Zagreb
• Defense date and country: 2023-03-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Kalcifikacije u projekciji karotidnih arterija na ortopantomogramu često predstavljaju
aterosklerotske plakove karotida, koji su učestali uzrok moždanog udara. Cilj rada jest
istražiti vrijednost prisutnosti kalcifikacija u projekciji karotida na ortopantomogramu u
otkrivanju njihova stupnja stenoze, analizirati povezanost rizičnih čimbenika, kalcifikacija
na ortopantomogramu i stupnja stenoze i odrediti učestalost sociodemografskih obilježja,
navika i dosadašnjih cerebrovaskularnih i kardiovaskularnih bolesti ispitanika. Ispitanicima
s kalcifikatima na ortopantomogramima učinjeni su UZV i MR karotida te MR mozga kako
bi se odredili prisutnost plaka i stupanj stenoze u arterijama te eventualni znakovi
cerebrovaskularne bolesti na MR­u. Klinički značajna stenoza (>50 %) nađena je kod 15,7
% ispitanika na UZV­u, odnosno 10 % na MRA­u, a još 30 % ispitanika imalo je stenozu
>30 %. Statistički značajna povezanost stenoze karotida >50 % i kalcifikacija na
ortopantomogramu nije dokazana. Postojala je statistički značajna povezanost obostranih
kalcifikacija i hipertenzije, dijabetesa te moždanog udara. Pacijenti s moždanim udarom i
kroničnim vaskularnim lezijama mozga bili su 5, odnosno 10 godina stariji. U slučaju nalaza
kalcifikacija u projekciji karotida na ortopantomogramu, osobito uz prisutne rizične
čimbenike, preporučljivo je pacijenta uputiti na dijagnostičku obradu kako bi se
aterosklerotske promjene karotida pravovremeno dijagnosticirale, a time i vršila prevencija
moždanog udara.

Abstract (english)

Aim: Calcifications in the projection of carotid arteries on orthopantomographs usually
represent calcified atherosclerotic plaques. Carotid atherosclerosis is one of the most
common causes of stroke. Our primary aim was to determine the significance of calfications
in the projection of carotids on orthopantomographs for detection of carotid artery stenosis.
Secondary aims of the study were to analyse the relationship between stroke risk factors,
calcifications in the projection of carotids on orthopantomographs, and the degree of carotid
stenosis, and to determine the prevalence of sociodemographic features, habits and previous
cardiovascular and cerebrovascular diseases of the subjects with calcifications on
orthopantomographs.
Materials and methods (participants and methods): Carotid color Doppler ultrasound,
carotid MR angiography and brain MRI were performed on 70 subjects with visible
unilateral or bilateral calcifications in the projection of carotid arteries on
orthopangomographs performed for dental indications. Carotids were screened
ultrasonically for the presence of atherosclerotic plaques, and the degree of carotid stenosis
was determined by ultrasound and MR angiography. Brain MRI was screened for existing
cerebrovascular disease. Anamnestic data relevant for stroke risk were gathered.
Results: Clinically significant carotid stenosis (>50%) was found for almost 16% of the
ultrasound subjects, and for 10% MR angiography subjects. Further 30% of the subjects had
a clinically non­significant, but existing stenosis of 30 – 50%. No statistically significant
correlation between calcifications in the projection of carotids on orthopantomography and
significant stenosis was found. A significant correlation between bilateral carotid
calcifications on orthopantomographs and hypertension (p<0,01) was found, and also
between bilateral carotid calcifications on orthopantomographs and diabetes, as well as
stroke (p<0,05). Subjects with stenosis <30% had 10kg lower body weight compared to
Mia Smoljan Basuga, disertacija______________________________________________________
subjects with higher degrees of carotid stenosis. Subjects afflicted by stroke were
approximately five years older than those without previous stroke, and subjects with signs
of chronic microvascular disease on brain MRI were approximately ten years older than
those without it.
Conclusion: One in every six to seven subjects with calcifications in the projection of
carotid arteries on orthopantomographs has significant carotid stenosis, and one in three to
four exhibits a 30 to 50% stenosis. By detecting the calcifications in the projection of carotids
on orthopantomographs in their daily practice, dental medicine doctors can take part in
primary stroke prevention, and should refer those patients to further diagnostics, especially
those with stroke risk factors, in particular hypertension and diabetes.

• Keywords: panoramska radiografija; stenoza karotidnih arterija; kalcifikacije
• Keywords (english): Panoramic Radiography; Carotid Stenosis; Vascular Calcification
• Language: croatian
• URN:NBN: urn:nbn:hr:127:076396
• Promotion: 2023
• Study programme: Title: Obtaining a doctorate of science outside of doctoral studies; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti (doktor/doktorica znanosti)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-03 08:49:57