Tuesday, December 13, 2022

Incidental findings in cone beam computed tomography volumes: calcified head and neck atheromas detected during dental evaluation

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Abstract

Purpose

Atheromas can be detected incidentally in routine dental cone beam computed tomography (CBCT) images. This study aims to assess prevalence and risk factors associated with these vascular lesions.

Materials and Methods

The maxillofacial CBCT's of 458 subjects were evaluated and divided into 4 groups based on the presence of calcified atheroma: subjects with no calcified atheroma, subjects with intracranial calcified atheroma (ICA), subjects with extracranial calcified atheroma (ECA), and subjects exhibiting combined lesions. Age, sex, medical conditions, family history, and size were documented. ANOVA followed by a multiple comparison test was used for data satisfying parametric test assumptions. Chi Square tests were used to assess categorical data. The Spearman's Rho test was used to assess the correlation between the incidence of calcified atheroma and subjects' medical condition.

Results

Of the 458 CBCTs evaluated, 29.90% presented with calcified atheroma. Calcified atheroma prevalence was significantly higher in older patients vs younger patients (p = 0.004) and in males compared to females (p = 0.004). Males were more likely to have the combination of intracranial and extracranial calcified atheroma while females were more likely to have intracranial calcified atheroma alone (p ≤ 0.040). Patients with calcified atheroma were significantly more likely to have a history of hyperlipidemia (p = 0.001), hypertension (p = 0.001), and myocardial infarction/coronary artery diseases (p = 0.001). Overall, patients exhibiting both intracranial and extracranial lesions were more likely to have cardiovascular risk factors (p = 0.001).

Conclusion

Incidentally detected calcified atheromas in CBCTs are common. Subjects with combined atheroma lesions are at higher risk for cardiovascular disease. The diagnosis of incidental calcified atheromas in CBCT's warrants early referral to medical specialists, especially if there is no medical history of existing cardiovascular disease.

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