Diagnostic Imaging of Carotid Artery

In the study of carotid arteries, the different imaging techniques allow to analyze various diseases like stenoses, aneurysms, thromboses, dissections, diseases caused by atherosclerotic plaques or congenital abnormalities. The diagnostic modalities that are used to image the carotid artery diseases are digital subtraction angiography (DSA), duplex ultrasound (DUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). The goal of the diagnostic imaging is to provide screening and to detect diseases at its earliest and most treatable stage. As initial screening study, the radiologists recommend DUS. It is a safe and painless way to produce pictures of the inside of the body using sound waves. It assesses blood flow in the carotid arteries, measures the speed of the blood flow, and estimates the diameter of a blood vessel and degree of obstruction. Digital subtraction angiography (DSA) has assumed a major role in the evaluation of occlusive cerebrovascular disease. While digital subtraction angiography (DSA) is still considered the gold standard, it has increasingly been replaced by computed tomography angiography (CTA) or magnetic resonance angiography (MRA) during the last years. Modern imaging studies like CTA and MRI allow to obtain three-dimensional reconstruction of anatomic structures and pathological abnormalities. Computed tomography angiography (CTA) of carotid arteries is a standardized procedure with excellent image quality but related with high radiation exposure. The rapid technical evolution in hardware and software allows even smaller imaging centers to perform high-quality vessel imaging. During the last decade, CTA came up with substantial progress in terms of accuracy in stenosis and aneurysm detection. Magnetic resonance angiography (MRA) is increasingly used as a noninvasive method to assess carotid arteries. Diseases like carotid artery dissections could be detected by using MRA or CTA