Pearls and Pitfalls of Carotid Artery Imaging: Ultrasound, Computed Tomography Angiography, and MR Imaging

Radiol Clin North Am. 2023 May;61(3):405-413. doi: 10.1016/j.rcl.2023.01.001. Epub 2023 Feb 9.

Abstract

Stroke represents a major cause of morbidity and mortality worldwide with carotid atherosclerosis responsible for a large proportion of ischemic strokes. Given the high burden of the disease , early diagnosis and optimal secondary prevention are essential elements in clinical practice. For a long time, the degree of stenosis had been considered the parameter to judge the severity of carotid atherosclerosis. Over the last 30 years, literature has shifted attention from stenosis to structural characteristics of atherosclerotic lesion, eventually leading to the "vulnerable plaque" model. These "vulnerable plaques" frequently demonstrate high-risk imaging features that can be assessed by various non-invasive imaging modalities.

Keywords: CTA; Carotid arteries; MRA; US; Vulnerable plaque.

Publication types

  • Review

MeSH terms

  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / pathology
  • Carotid Artery Diseases* / complications
  • Carotid Artery Diseases* / diagnostic imaging
  • Carotid Stenosis* / complications
  • Carotid Stenosis* / diagnostic imaging
  • Computed Tomography Angiography
  • Constriction, Pathologic / complications
  • Humans
  • Magnetic Resonance Imaging
  • Plaque, Atherosclerotic* / complications
  • Plaque, Atherosclerotic* / diagnosis
  • Plaque, Atherosclerotic* / pathology