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

Background: The aim of our study was to determine potential opportunities for routine radiological examinations (dental panoramic radiography (DPR), cervical spine radiography (CSR), cone beam computed tomography (CBCT) and multislice computed tomography (MSCT)) in the identification of carotid artery calcifications (CAC) as radiological signs of asymptomatic carotid artery disease (ACAD). Methods and Results: The retrospectively evaluated results of the digital DPR were used for 4367 patients, CSR - 857 patients, CBCT - 582 patients, and MSCT - 377 patients. Mean age of patients was more than 55 years. The overall detectability of CAC during DPR, CSR, CBCT, and MSCT was 8.3%, 15.9%, 13.1%, and 40.6%, respectively. The gender difference in favor of women was observed during DPR, CBCT and MSCT and in favor of men - only during CSR. CAC should be sought at the level of C3-C4 intravertebral discs in the cervical soft tissues, more often on the one side, in the form of solitary/multiple, friable, homogenous/heterogeneous radiopaque shadows smaller than 0.5 cm. Conclusion: CAC indicates the presence of a high risk of developing ischemic stroke, which means that the above modalities have to be used as a tool to identify the predictor of this pathological condition of the cardiovascular system.