[Imaging of vessels supplying the brain]

Area of Science:

• Neuroimaging
• Vascular Neurology
• Medical Diagnostics

Background:

• Multiple imaging modalities exist for evaluating arteries supplying the brain.
• Accurate imaging is vital for diagnosing cerebrovascular diseases and guiding treatment.
• The choice of imaging modality depends on the clinical scenario and diagnostic question.

Purpose of the Study:

• To review the roles of various imaging techniques in cerebrovascular disease assessment.
• To highlight the importance of specific modalities in acute stroke and stenosis evaluation.
• To clarify the diagnostic utility and limitations of different imaging methods.

Main Methods:

• Review of computed tomography (CT) angiography for acute stroke and recanalization criteria.
• Evaluation of ultrasound imaging for extracranial internal carotid artery (ICA) stenosis grading.
• Assessment of magnetic resonance imaging (MRI) and MR angiography for dissection and global circulation.
• Discussion of digital subtraction angiography (DSA) in interventional procedures.

Main Results:

• CT angiography is essential for diagnosing acute stroke and identifying candidates for recanalization.
• Ultrasound is optimal for detecting and grading ICA stenosis, guiding revascularization.
• MRI excels at detecting arterial dissection, while MR angiography provides a broader view.
• DSA is primarily used for interventional procedures, less so for diagnosis alone.

Conclusions:

• Different imaging modalities serve specific, crucial roles in cerebrovascular diagnostics.
• CT angiography and ultrasound are key in acute stroke and ICA stenosis management, respectively.
• Ultrasound is not indicated for vertigo/syncope and offers no benefit for asymptomatic individuals.