Neurosonology and noninvasive imaging of the carotid arteries

In this chapter, we review imaging of the extracranial carotid arteries and the indications for noninvasive carotid artery evaluation, measuring the degree of arterial stenosis and plaque morphology. We also analyze the types of noninvasive imaging, including carotid duplex ultrasound, transcranial Doppler, magnetic resonance angiography, and computer tomography angiography. We look at each of these modalities, briefly discussing techniques, benefits, limitations, and sources of error. Furthermore, we discuss the apparent accuracy and the need for multimodality imaging. Finally, an imaging algorithm for the evaluation of the extracranial carotid arteries is proposed, which is in routine use at our hospital.