Purpose: The aim of this article is to evaluate the CT findings of malignant tumors of upper cervical lymph nodes invading the carotid sheath.
Methods: Seventy-seven patients (83 lesions) with malignant tumors in the upper cervical lymph nodes shown on CT scans were collected. All lesions were certificated with pathological examination by operation or biopsy.
Results: The CT manifestations of malignant tumors of upper cervical lymph nodes invading the carotid sheath included :(1) compression and deformation of vessels in the carotid sheath in 52 lesions (ICA, one lesions; ICV, 51 lesions); (2) disappearance of vessels in the carotid sheath (ICV, 13 lesions); (3) displacement of vessels of the carotid sheath in 67 lesions (ICA, 22 lesions; ICV, 50 lesions); and (4) malignant tumors encompassing the carotid sheath in 15 lesions.
Conclusions: On CT images, the most common form of malignant lymph node lesions invading the carotid sheath is displacement of ICA and ICV. It is concluded that all forms of affecting carotid sheath demonstrating on the CT images are important in diagnosing the malignant invasion of the ICA and ICV.