Tomografia computadorizada de feixe cônico: modificação do protocolo de obtenção de imagens para diagnóstico precoce de alterações principais e incidentais de cabeça e pescoço

Abstract

This study aims at proposing a protocol using an IS of greater amplitude, the image acquisition phase generated by the dedicated type devices together with the setting software usage parameters in interpreting the postprocessing reconstructed images to obtaining more comprehensive diagnostics in the regions of the head and neck. This allows raising the multidisciplinary care between medical and dental areas to thereby increase the chances of incidental detections that are beyond the initial reason for the referral. To prove the possibility of enhancing the incidental findings, a survey in DICOM files (Digital Imaging and Communication in Medicine) of patients treated in private clinic was conducted from January 2012 to July 2015, and extended FOV (Field of view- device field of vision) allows, then a more extensive capture the head and neck regions. And in the reconstruction options post-processing images was used to pre-set set-ups in the i-CatVision software, providing a greater chance of structural visualization, especially when involving soft tissue regions. Totalizing 223 patients considered the standard for the study, they found themselves dental repercussions in 77.57% of present changes in bone regions of maxilla and mandible, including 23.31% of periapical lesions without any previous endodontic treatment and also changes in regions of the temporomandibular joint in 54.23%. The events outside the area of ​​primary interest related to medical specialties were a percentage of 67.26% of cases. In paranasal sinuses 57.84%, mineralization or calcifications in the soft tissues at 45.37%, as found in the thyroid spaces and particularly when located in vascular areas of the extracranial and intracranial carotid regions comprised respectively in the "Carotid Bulb" and called "Polygon of Willis' enabling perhaps a greater chance of early detection of serious chronic degenerative diseases such as atherosclerosis and all its consequences, contributing to the maintenance of general health of patients. Thus, it can be seen that with modification of the FOV and tool adjustments in the software post-processing, provided a higher chance of detecting incidental changes. It was evident, then, a direct relationship between the amplitude of the FOV and the diagnosis of incidental findings.