Investigating the sensitivity of portable ultrasound probe to detect carotid artery calcification compared to CBCT

Carotid artery calcification is an important predictor of atherosclerosis that associated with an increased risk of stroke and can be detected through panoramic radiography, Doppler ultrasound, or cone-beam computed tomography (CBCT) imaging modality. This study aimed to assess the sensitivity of a portable ultrasound probe in detecting carotid artery calcification compared to CBCT results. This cross-sectional diagnostic study was conducted on 60 patients(> 30 years old) who were referred to the Department of Oral and Maxillofacial Radiology at Islamic Azad University, Isfahan, Iran. Individuals with calcifications identified on CBCT and subsequently examined portable ultrasonography. All imaging were evaluated independently for the right and left carotid arteries and were performed using NNT (NewTom) and ultrasonography through Clarius L15HD3 probe software. The images were evaluated by specialists in oral and maxillofacial radiology and cardiology, and the data were analyzed using SPSS version 27, with p < 0.05 considered statistically significant. Carotid artery calcification lesions increased significantly with age ( p < 0.05). Although lesions were more frequent in females, the difference was not statistically significant. Also, unilateral carotid artery involvement was more common than bilateral involvement, with no significant difference between the right and left sides. The lesions were predominantly solitary, and the distribution of morphological patterns differed considerably between the two genders ( p < 0.05). Portable ultrasonography performed better in detecting lesions ≥ 2 mm. CBCT is useful for the incidental detection of carotid artery calcifications. Portable ultrasonography can identify larger lesions but is not sufficiently sensitive for smaller calcifications. In this study, ultrasonography detected only 4.3% of lesions smaller than 2 mm, while it identified all lesions measuring 2–4 mm and larger than 4 mm (100% sensitivity), with an overall sensitivity of 41%. Therefore, incidental detection of carotid artery calcifications on CBCT may warrant appropriate referral for further clinical and vascular evaluation.