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

الملخص EN

Background : Stroke is the third leading cause of death in United States today, it is also the leading cause of severe disability (1, 2).

The most well-known risk factor for the development of stroke is high-degree internal carotid artery stenosis (3).

Stroke may be preventable (but the major challenge is to find effective methods of detection of strokeprone patients).

The aim of this study was to compare the prevalence of cervical carotid arteries stenosis among healthy and non insulin dependent diabetes mellitus Iraqi postmenopausal women sample also correlating carotid artery calcification detected on digital dental panoramic tomography with carotid stenosis determined by Doppler ultrasound.

Materials and methods : The Digital Dental Panoramic Tomographs was taken to the sample and observed for presence or absence of any radiopacity in the soft tissue region at the bifurcation of common carotid artery.

Many parameters were measured by Doppler ultrasound include peak systolic velocity, peak end diastolic velocity for Internal and common carotid arteries, Ratio of velocities for Internal Carotid / velocities for Common Carotid and Ratio ; Measure the reduction in lumen diameter and area of Internal and Common Carotid to calculate the percentages of Linear stenosis and area stenosis of the two arteries ; detect presence of Carotid plaque in right and left sides .

Results : The sensitivity of the diagnostic performance of Digital panoramic tomograph in predicting atheromal plaque and final diagnosis of significant stenosis, atheromal plaque detected by Doppler in predicting final diagnosis of significant stenosis was higher when the risk increase (higher in type II diabetic group).

No statistically significant differences between control group and type II diabetic group regarding finding on panoramic radiograph although the prevalence ratio in type II diabetic group higher than control .

Calcification finding shows statistical significant difference 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 atheromal plaque finding on Doppler.

Although the prevalence ratio of ffinal diagnosis of significant stenosis in type II diabetic group 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 being employed (employed had less).

Statistically found that there was significant differences between those had FDSS or not in the mean of low density lipoprotien in type II diabetic group.

The prevalence rate of atheroma, final diagnosis of significant 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 Final diagnosis 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 and calcifications .The diagnostic performance of CAC detected by DDPT as a diagnostic tool for plaque detected by Doppler and the diagnostic performance DDPT and AP detected by DUS in predicting FDSS had higher sensitivity and PPV in type IIDM group than healthy .The dentist able to discover asymptomatic significant stenosis in patient with carotid artery Calcification on panoramic radiograph and should refer these patients to physician for determination the magnitude of the disease by further examination this referral had similar importance when radiologist discover in patient atheromal plaque detected by Doppler ultrasound and do further investigation by Doppler to determine the magnitude of the disease and find asymptomatic significant stenosis .