[Modern cross-sectional imaging of head and neck vessels]

Although digital subtraction angiography (DAS) remains the gold standard for neurovascular imaging, the number of diagnoses made on the basis of less invasive cross-sectional imaging techniques (CT and MR angiography) is increasing. The present article provides important technical principles of CT and MR angiography, followed by an analysis of the diagnostic possibilities and limitations of vascular cross-sectional imaging. The particular importance of post-processing of vascular cross-sectional datasets is also discussed. Using the typical clinical diagnostic work-up of extra- and intracranial vascular diseases as a basis, the article explains how a suitable examination technique and protocol is chosen and which limitations need to be borne in mind. After taking at look at the technical advances expected in the future (3-Tesla MRA, dual-energy CTA, post-processing workflow in PACS), the remaining indications for diagnostic DSA will be presented and explained.