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Unknown internal carotid artery atherosclerotic stenoses detected with biphasic multidetector computed tomography for head and neck cancer

  • Vascular-Interventional
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Abstract

The possibility of detecting unknown internal carotid artery stenoses in patients undergoing biphasic multidetector computed tomography (MDCT) for current or previous head and neck cancer was investigated in 52 patients who underwent four-row MDCT (4 mm×1.25 mm collimation, pitch 3, kVp 120, mAs 140; 90–100 ml of non-ionic contrast agent at 2 ml/s, early and late phases). Vessel stenoses were classed as severe (70–99%), moderate (30–69%), or mild (<30%). Internal carotid arteries (ICAs) with vessel stenosis was found in 37 patients (age 67.0±9.8 years, median 69 years) and 67 ICAs. Four patients (age 65.5±9.7 years) had severe stenosis, all of them associated with contralateral moderate stenosis. Seventeen patients (age 70.35±9.78 years) had moderate stenosis, bilateral (n=7), associated with contralateral mild stenosis (n=8), unilateral (n=2). Sixteen patients (age 64.8±9.8 years) had mild stenosis, bilateral (n=10) or unilateral (n=6). Of the four patients with unknown MDCT-detected severe stenosis, three had a change of therapy: one endarterectomy before tumor surgery, one combined vascular and tumor surgery, and one patient with a previously treated hypopharyngeal cancer had carotid stenting. In conclusion, of 52 patients, four (7.7 %) had unknown severe ICA stenoses, three of them with relevant impact on therapy. ICAs should be carefully evaluated for atherosclerotic disease using biphasic MDCT for head and neck cancer.

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Acknowledgments

We would like to thank Piero Di Mauro and Thomas Denkewitz (anesthesiologists in the Intensive Care Unit of our hospital ) for their suggestions about ICA stenosis, such as preoperative risk factors in head and neck cancer patients, and Laura Boschiroli (physicist in the Department of Clinical Engineering of our hospital) for her calculations of radiation exposure for our MDCT protocol.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University of Milan, San Paolo Hospital, Via A. Di Rudinì 8, 20142, Milan, Italy

    Nicola Flor, Simone Soldi, Giuseppe Franceschelli, Caterina Missiroli & Gianpaolo Cornalba

  2. Department of Radiology, University Hospital Istituto Policlinico San Donato, Milan, Italy

    Francesco Sardanelli

  3. Department of Head and Neck Surgery, European Institute of Oncology, Milan, Italy

    Fiora De Paoli

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  1. Nicola Flor
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  2. Francesco Sardanelli
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  3. Simone Soldi
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  4. Giuseppe Franceschelli
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  5. Caterina Missiroli
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  6. Fiora De Paoli
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  7. Gianpaolo Cornalba
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Correspondence to Nicola Flor.

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Flor, N., Sardanelli, F., Soldi, S. et al. Unknown internal carotid artery atherosclerotic stenoses detected with biphasic multidetector computed tomography for head and neck cancer. Eur Radiol 16, 866–871 (2006). https://doi.org/10.1007/s00330-005-0023-2

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  • DOI: https://doi.org/10.1007/s00330-005-0023-2

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