title: [Use of imaging criteria to identify cervical metastases using CT scans in head and neck tumours].
abstract: OBJECTIVE
  To assess the diagnostic certainty of CT images to identify regional spread of head and neck tumours.
  
  
  METHODS
  A CT study was performed on 86 patients with neoplasms in the larynx and/or pharynx. After this, surgical dissection was performed for 142 neck sides. In the imaging study the following parameters were considered for all patients before suspecting malignant nodes: size of adenopathy bigger than 10-11 mm, irregular borders, central necrosis, spherical shape, capsular enhancement and presence of groups with three or more lymphadenopathies.
  
  
  RESULTS
  48.5 % of dissections were N+. Sensitivity and specificity for physical examination were 59 % and 82 %, respectively, against 73 % and 86 % for CT. Lymph node necrosis was the pattern with the greatest sensitivity and specificity (35.8 % and 100 %, respectively) and its accuracy was 69.7 %. Accuracy was 60.5 % for spherical shape, 59.8 % for node size, and between 54 % and 58 % for the other three criteria. In the histopathological findings, 25 % of neck dissections were N+ when only one pattern had been detected on CT, whereas those neck sides in which four patterns were identified simultaneously showed regional spread in 100 %.
  
  
  CONCLUSIONS
  The presence of specific morphological imaging criteria for head and neck tumours in cervical lymph nodes and their concomitance increase the accuracy of imaging to predict regional spread.
authors.affiliation: Servicio de Otorrinolaringología. Hospital Clínico Universitario de Valencia. Universidad de Valencia. Valencia. España. jgarciacall@hotmail.com
authors.forename: F Javier
authors.initials: FJ
authors.lastname: García Callejo
authors.forename: Delfina
authors.initials: D
authors.lastname: Dualde Beltrán
authors.forename: Elena
authors.initials: E
authors.lastname: Benlloch Ramos
authors.forename: M José
authors.initials: MJ
authors.lastname: Montoro Elena
authors.forename: Marta
authors.initials: M
authors.lastname: Hernandorena González
authors.forename: Jaime
authors.initials: J
authors.lastname: Marco Algarra
mesh_terms: D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology*; D008137:Longitudinal Studies; D010610:Pharyngeal Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*