Relevance of 5 different imaging signs in the evaluation of carotid artery invasion by cervical lymphadenopathy in head and neck squamous cell carcinoma.
OBJECTIVE
The aim of this retrospective study was to determine the relevance of 5 different imaging signs in the evaluation of carotid artery invasion.


METHODS
Between September 2001 and September 2008, 22 patients (20 men and 2 women) presented with lymph node metastasis of a head and neck squamous cell carcinoma that invaded the carotid artery. The patients received either carotid artery dissection (CAD, group 1 [n = 17]) or carotid resection (group 2 [n = 5]). Preoperative images using CT (n = 18) and/or MRI (n = 14) were analyzed.


RESULTS
In 1 of 17 cases in group 1 and in 5 of 5 cases in group 2, encasement of more than 180 degrees of the artery was present (P < .05). Segmental obliteration of the fat between the lymph node and the carotid artery was noted in 7 of 17 cases in group 1 and for all cases in group 2 (P < .05). Deformation of the carotid artery was reported in no cases in group 1 and in all cases in group 2 (P < .05).


CONCLUSIONS
The combination of deformation of the carotid artery, encasement of more than 180 degrees of the carotid perimeter, and segmental obliteration of the fat between the adenopathy and the carotid artery was highly predictive of massive invasion of the carotid artery, which would require a resection en bloc. In comparison, the isolated existence of encasement of more than 180 degrees or segmental obliteration of fat could not strictly indicate massive invasion of the carotid artery; thus, CAD could be planned.
Pons
Yoann
Y
Head and Neck Surgery Department, Radiology Department, Val de Grâce Hospital, Paris, France. pons.yoann@gmail.com
Ukkola-Pons
Elsa
E
Clément
Philippe
P
Gauthier
Jérome
J
Conessa
Claude
C
D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D004210:Dissection / Q000379:methods; D004547:Elastic Tissue / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media