Use of dynamic MRI during swallowing to assess carotid artery invasion by neck metastasis.

Abstract

The effectiveness of dynamic MRI in evaluating the relationship between metastatic lymph nodes and the carotid artery was investigated. Thirty-two patients with metastatic lymph nodes, possibly adherent to the carotid artery, were evaluated with dynamic MRI before surgery. Consecutive axial and oblique images were obtained during swallowing. The displacement rate of the target carotid artery to the contralateral carotid artery and the low-intensity stripe between the metastatic lymph nodes and the carotid artery wall were compared with the surgical findings. A displacement rate > 50% indicated resectable metastatic lymph nodes. Low-intensity stripe was present in 65% of patients and indicated no invasion; 82% of patients without low-intensity stripe had resectable metastatic lymph nodes. The others without low-intensity stripe required carotid artery resection due to malignant invasion. The accuracy rate, sensitivity, and specificity were 78%, 83%, and 100%, respectively. Dynamic MRI during swallowing is useful for assessing suspected carotid artery involvement in patients with metastatic lymph nodes to achieve maximal safe resection.