Objective：To investigate the identification value of vascular displacement direction in carotid space on lymph node-de－rived and neurogenic lesions in neck Ⅱ-Ⅳ area. Methods：A total of 33 patients whose lesions were pathologically confirmed in the neck Ⅱ-Ⅳ area from 1st January 2017 to 15th April 2019 were collected

including lymph node-derived lesion（n=26，including seven patients of lymph node tuberculosis，eight patients of lymph node metastasis，seven patients of lymphoma and four patients of lymphnoditis） and neurogenic lesion（n=7，including six patients of schwannoma and one patient of neurofibroma）. Besides the obvi－ous signs of lesion size，boundary，shape，density and enhancement ways and degree

the vascular displacement direction received more attention. Results：There were no significant differences in size（Z=-1.456，P=0.145），boundary（ ?字2=0.480，P=0.652），shape（?字2=2.257，P=0.190），density（ ?字2=1.451，P=0.378），ways of enhancement（ ?字2=1.188，P=0.664），and degree of enhancement（ ?字2=5.579，P=0.084） between two groups. In contrast，26 patients（100%） with lymph node lesion had inward displacement，carotid space vascular moving inside，six patients with neurogenic lesion（85.7%） had outward displacement，and one patient with neurogenic lesion（14.3%） had inward displacement

with statistically significant differences（ ?字2=27.238，P=0.000）. Conclusion：The direction of vascular displacement in carotid space can be used to identify the lesion from lymph node or nerve in the neck Ⅱ-Ⅳ area.