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Non-invasive imaging of the cervical carotid and vertebral arteries

¹ Department of Radiology, St George's Hospital, Blackshaw Road, London SW17 0QT and ² Section of Academic Radiology, Floor C, Royal Hallamshire Hospital, University of Sheffield, Glossop Road, Sheffield S10 1SJ, UK

• Disease at the carotid bifurcation is most commonly owing to atherosclerosis.
  
• Trial data indicate that intervention is beneficial for patients with high grade symptomatic stenoses.
  
• Cerebral angiography remains the reference standard, but is invasive.
  
• In experienced hands, colour duplex ultrasound is able to reliably grade stenoses and is also able to give information about plaque morphology.
  
• A variety of techniques may be used to produce MR angiograms to reliably image the carotid system from the aortic arch to the Circle of Willis
  
• Carotid dissection tends to affect a younger age group and is best imaged with a combination of duplex ultrasound and MR angiography.
  

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