The prevalence of cervical carotid arteries stenosis and calcifications among sample of Iraqi diabetic postmenopausal women detected by using Doppler sonography and digital dental panoramic tomography

H. AL-Nakib, Lamia; H. Hussein Al- Saleem, Baydaa

	The prevalence of cervical carotid arteries stenosis and calcifications among sample of Iraqi diabetic postmenopausal women detected by using Doppler sonography and digital dental panoramic tomography
Journal of baghdad college of dentistry
Article 1, Volume 23, Issue 3, 2011, Pages 50-55
Authors
Lamia H. AL-Nakib; Baydaa H. Hussein Al- Saleem
Abstract
ABSTRACTBackground: Stroke is the third leading cause of death in United States today, it is also the leading cause of severedisability (1,2). The most well-known risk factor for the development of stroke is high-degree internal carotid arterystenosis (3). Stroke may be preventable (but the major challenge is to find effective methods of detection of strokepronepatients). The aim of this study was to compare the prevalence of cervical carotid arteries stenosis amonghealthy and non insulin dependent diabetes mellitus Iraqi postmenopausal women sample also correlating carotidartery calcification detected on digital dental panoramic tomography with carotid stenosis determined by Dopplerultrasound.Materials and methods: The Digital Dental Panoramic Tomographs was taken to the sample and observed forpresence or absence of any radiopacity in the soft tissue region at the bifurcation of common carotid artery. Manyparameters were measured by Doppler ultrasound include peak systolic velocity, peak end diastolic velocity forInternal and common carotid arteries, Ratio of velocities for Internal Carotid/ velocities for Common Carotid andRatio; Measure the reduction in lumen diameter and area of Internal and Common Carotid to calculate thepercentages of Linear stenosis and area stenosis of the two arteries; detect presence of Carotid plaque in right andleft sides .Results: The sensitivity of the diagnostic performance of Digital panoramic tomograph in predicting atheromalplaque and final diagnosis of significant stenosis, atheromal plaque detected by Doppler in predicting final diagnosisof significant stenosis was higher when the risk increase (higher in type II diabetic group) .No statistically significantdifferences between control group and type II diabetic group regarding finding on panoramic radiograph although theprevalence ratio in type II diabetic group higher than control . Calcification finding shows statistical significantdifference regarding being employed and age (un employed over and over 60 years subjects had more calcification).Statistical significant difference was found between control and type II diabetic group regarding carotid atheromalplaque finding on Doppler. Although the prevalence ratio of ffinal diagnosis of significant stenosis in type II diabeticgroup 5 times higher than control group, the observed increased risk failed to reach the level of statistically significant,also final diagnosis of significant stenosis shows statistically a significant difference regarding beingemployed(employed had less) . Statistically found that there was significant differences between those had FDSS or notin the mean of low density lipoprotien in type II diabetic group. The prevalence rate of atheroma, final diagnosis ofsignificant stenosis and Carotid calcifications were higher in unemployed subjects and sedentary life style.Conclusions: The highest risk group in relation to had Carotid artery calcifications, atheromal plaque and Finaldiagnosis of significant stenosis detected by Doppler ultrasound was in type IIDM group.Encouragement of physical activity and sports may reduce the prevalence rate of atheroma, FDSS andcalcifications .The diagnostic performance of CAC detected by DDPT as a diagnostic tool for plaque detected byDoppler and the diagnostic performance DDPT and AP detected by DUS in predicting FDSS had higher sensitivityand PPV in type IIDM group than healthy .The dentist able to discover asymptomatic significant stenosis in patientwith carotid artery Calcification on panoramic radiograph and should refer these patients to physician fordetermination the magnitude of the disease by further examination this referral had similar importance whenradiologist discover in patient atheromal plaque detected by Doppler ultrasound and do further investigation byDoppler to determine the magnitude of the disease and find asymptomatic significant stenosis .Key words: carotid stenosis. Doppler ultrasound. Panoramic radiograph. (J Bagh Coll Dentistry 2011;23(3): 50-55).

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