Ultrasonography is more effective than computed tomography in excluding invasion of the carotid wall by cervical lymphadenopathies.

Twelve patients with head and neck cancer, bulky lymphadenopathies, and clinical suspicion of carotid artery infiltration, had preoperative CT and US. The results of both techniques were correlated with surgical findings (one case of invasion and 11 of non-invasion), to evaluate the role of CT and US in the preoperative diagnosis of tumor invasion of the carotid wall. While CT showed a high level of failures (11 false positives and one true positive), US (one true positive, one false negative, and 10 true negatives) appears to be an easy and helpful method for predicting non-invasion of the carotid wall. However, the usefulness of US in detecting invasion cannot be evaluated, due to the limited number of positive cases.