the predictive value of computed tomography in jugular vein by head and neck tumors

abstract: introduction & objective: awareness of invasion of the walls of the cervical vessels by tumor is of great clinical importance before surgery. this study was designed to assess the diagnostic worth of computed tomography (ct) in distinguishing jugular vein (jv) invasion by oral –maxillofascial and neck malignant tumors. material & methods: ct with contrast was performed on 46 patients who had oral –maxillofascial and neck malignant tumors before surgical intervention. the ct appearance of all tumors was prospectively compared with surgical findings. results: the abnormal ct manifestation of the patients with jv involvement consisted of 5 types: type i, tumor encasement of greater than 270 degrees of circumference of the jugular vein in 8 tumors type ii, tumor encasement of greater than 180 degrees of circumference of the jugular vein in 13 tumors type iii, compression of jv in 10 and displacement of jv in 3 tumors type iv, the segmental deletion of fat planes between tumor and jv in 20 tumors type v, obliteration of jv on segmental axial ct views in 7 tumors. the sensitivity, specificity and positive predicative value were 34.4%, 86.7% and 80% for type i, 59.1%, 66.7% and 72.2% for type ii, 57%, 62.5% and 54.4% for type iii, 91%, 45.8% and 60.5% for type iv and 38%, 88% and 70% for type v. in addition, correlation coefficient of jv for types i and iv was statistically significant. conclusion: although a variety of ct findings was helpful in assessing the jv but types i and iv had more accuracy. our study demonstrated that although ct images were not an accurate and definite way of jugular vein assessment in head and neck tumors, they could be a useful approach in primary staging, tumoral extension and therapeutic management.