[Computed tomography diagnosis of maxillofacial and neck malignant tumors invading carotid artery].

Objective: To evaluate the diagnostic value of the carotid artery invasion by the oral-maxillofacial and neck malignant tumors with computed tomography (CT).
Methods: Fifty-three patients (55 tumors) of oral-maxillofacial and neck malignant tumors were examined with enhanced axial CT examination in pre-operation. The CT manifestations of all tumors were retrospectively corresponded with the surgical findings.
Results: Oral-maxillofacial and neck malignant tumors with abnormal common carotid artery (CCA) or internal carotid artery (ICA) manifestations were shown on CT as five types: type I, compression and deformation of CCA or ICA in six tumors; type II, displacement of CCA or ICA in 15 tumors; type III, the tumors encompass the carotid vessels more than 180 degrees in 8 tumors; type IV, the segmental deletion of fat or fascia planes between tumor and CCA/ICA in 25 tumors; and type V, ill-defined CCA/ICA wall in 12 tumors. Surgical findings recorded that 20 CCAs or ICAs were adhered by the oral-maxillofacial and neck malignant tumors. Of these 20 lesions, 14 malignant tumors (70%) with more than two abnormal changes of CCA or ICA were shown on CT images. The respective sensitivity, specificity and accuracy were 30.0%, 100.0% and 74.5% for type I, 20.0%, 68.6%, 50.9% for type II, 22.2%, 100.0%, 49.1% for type III, 90.0%, 80.0% and 83.6% for type IV, and 45.0%, 88.6% and 72.7% for type V.
Conclusions: The main CT findings of maxillofacial and neck malignant tumors affecting the carotid artery are different. Comparatively, the signs of type I, type III and type IV may be valuable in evaluating CCA or ICA invasion, although the accurate diagnosis of the CCA or ICA involvement by the maxillofacial and neck malignant tumors remains difficult.