CAROTID-ARTERY INVASION BY HEAD AND NECK MASSES - PREDICTION WITH MR-IMAGING

PURPOSE: To determine the value of magnetic resonance (MR) imaging in predicting resectability of head and neck neoplasms around the carotid arteries. MATERIALS AND METHODS: Forty-nine patients (28 male patient s and 21 female patients aged 17-79 years; mean, 57.3 years) with head and neck masses and clinical evidence of carotid wall invasion underw ent MR imaging. T1-weighted, T2-weighted, and gadolinium-enhanced T1-w eighted images were analyzed to determine circumferential involvement of 53 arteries by tumor. RESULTS: More than 270 degrees of circumferen tial involvement was considered suggestive of unresectability of the m alignant neoplasm; 270 degrees or less was considered lack of invasion . The sensitivity of MR imaging for determination of unresectable dise ase was 100% (12 of 12 cases), specificity was 88% (36 of 41), and acc uracy was 91% (48 of 53). Accuracy was 100% for squamous cell carcinom a (n = 29). CONCLUSION: Tumor that encompasses more than 270 degrees o f the carotid artery probably cannot be removed from the artery. Tumor that involves 270 degrees or less of the artery can be removed.