Internal carotid artery calcifications in a South African population : a CBCT imaging study

Abstract

BACKGROUND : Stroke is the second leading cause of death globally and account for 25,000 deaths annually in South Africa. Both medial and intimal located intracranial internal carotid artery (iICA) calcifications are associated with stroke. Cone beam computed tomography (CBCT) is commonly used where advanced dental imaging of the skull is required and often includes areas outside of the field of interest. Modalities such as CBCT have great potential to identify and provide early detection of calcifications during imaging for dental purposes. The aim of the study was to investigate the presence, distribution and extent of iICA calcifications in a South African population using CBCT images. Retrospectively collected CBCT data sets of 582 patients were evaluated. All data sets were evaluated for the presence, location and severity of calcifications within the course of the internal carotid artery. RESULTS : Age was associated with a higher prevalence of internal carotid artery (ICA) calcifications, but sex was not. Individuals older than 61 years presented with a high number of calcifications. In total, the presence of calcifications was found in 199 patients (i.e. 34.19% of the patients). White South African individuals showed the highest prevalence. A higher degree of calcifications was also present within the C4, C5 and C6 ICA segments. CONCLUSIONS : Detection of calcifications along the course of the ICA was possible using CBCT images taken for dental treatment purposes. Early detection of calcifications allows for appropriated referral and assessment which will be beneficial to the patient presenting with ICA calcifications.