Article Figures & Data
Figures
- Fig 1.
Reference for grading the position of the carotid artery: axial contrast-enhanced CT images of the neck soft tissues at the level of the oropharynx (A) and hypopharynx (B). The vertical reference lines represent the lateral margin of the pharynx. The lines are drawn along the lateral margin of the oropharyngeal wall/palatine tonsil in A and the inner cortex of the thyroid cartilage (which approximates the lateral hypopharyngeal wall) in B. The position of the carotid artery at each level can then be graded with respect to these reference lines.
- Fig 2.
Images representing the “turn” (A), “nod” (B), and “tilt” (C) axes used to calculate head position. A, The amount of rotation in the “turn” axis was measured in degrees of rotation of the nasal septum with respect to the vertical. B, The amount of rotation in the “nod” axis was measured in degrees of rotation of the hard palate from the horizontal. C, The amount of rotation in the “tilt” axis was measured in degrees of rotation of the hard palate with respect to a line drawn along the superior aspects of the clavicular heads.
- Fig 3.
A 58-year-old man with mantle cell lymphoma. A, The proximal left internal carotid artery (arrow) position is retropharyngeal (grade 2). The proximal left external carotid artery can be seen lateral to the internal carotid artery. This image was obtained immediately superior to the common carotid bifurcation. The superior cornu of the thyroid cartilage lies between and just anterior to the 2 structures. B, On a scan obtained 1 year earlier, the proximal left internal carotid artery (arrow) position is lateral (grade 0). The proximal left external carotid artery can be seen just anterior to the internal carotid artery, and the superior cornu of the thyroid cartilage lies medial to the internal carotid artery. This image was also obtained immediately superior to the common carotid bifurcation. C, A coronal reformatted image shows the right common carotid bifurcation (black arrow) and the left common carotid bifurcation (white arrow). The superior cornu of the thyroid cartilage can be seen between the proximal internal and external carotid arteries bilaterally. Both internal carotid arteries are retropharyngeal. D, A coronal reformatted image from the examination obtained 1 year earlier (shown in B) shows that the proximal left internal carotid artery (white arrow) lies lateral to the superior cornu of the thyroid cartilage, whereas the proximal right internal carotid artery remains retropharyngeal.
- Fig 4.
A 46-year-old man with Hodgkin lymphoma. A, The right internal carotid artery (arrow) position is lateral (grade 0). Both the proximal internal and external carotid arteries are lateral to the greater cornu of the hyoid bone. This image was obtained immediately above the level of the common carotid bifurcation. B, On a scan obtained 6 months earlier, the proximal right internal carotid artery (arrow) position is retropharyngeal (grade 2), located medial to the greater cornu of the hyoid bone. This image was also obtained immediately above the level of the common carotid bifurcation.
Tables
Only Lateral At Least 1 Marginal and No Retropharyngeal At Least 1 Retropharyngeal Age (yr) (mean) (min–max) 44.9 (4–74) 55.5 (2–76) 60.5 (37–78) Atherosclerosis grade (mean) (min–max) 0.55 (0–3) 1.00 (0–3) 1.12 (0–3) Note:—min indicates minimum; max, maximum.
- Table 2:
Demographic data, diagnoses, and imaging features of patients with moving carotid arteries
Patient Age (yr) Sex Diagnosis Atherosclerosis Grade Moving Segment Level of Retropharyngeal Carotid Time Interval between Scans (mo) Head Position 1 58 Male HematoCA 0 Left ICA Oropharynx 8 Tilted 10° down between scans 2 46 Male HematoCA 0 Right ICA Oropharynx 6 Neutral; no change 3 71 Male Skin cancer 2 Left CCA Hypopharynx and oropharynx 4 Tilted 10° down between scans 4 56 Female Lung cancer 2 Right ICA Oropharynx 2 Neutral; no change Note:—CCA indicates common carotid artery; HematoCA, hematologic malignancy.
