Imaging of Carotid Dissection.

Area of Science:

• Vascular Imaging
• Neurology
• Radiology

Background:

• Carotid artery dissection (CAD) is a tear in the inner lining of the carotid artery, potentially causing stroke.
• Common symptoms include head and neck pain, but severe neurological events can occur.
• Genetic factors are increasingly recognized in the etiopathogenesis of cervical artery dissection.

Purpose of the Study:

• To review the four primary imaging modalities for identifying carotid artery dissection.
• To discuss the advantages, limitations, and clinical considerations of each modality.
• To describe the specific imaging characteristics of carotid dissection for each method.

Main Methods:

• Review of current literature on carotid artery dissection imaging.
• Description of Magnetic Resonance Angiography (MRA), Computed Tomographic Angiography (CTA), Carotid Duplex Imaging (CDI), and Digital Subtraction Angiography (DSA).
• Highlighting advanced MRI techniques like fat suppression, SWI, and MSDE.

Main Results:

• MRI/MRA with fat suppression is considered the best initial screening test for dissection.
• Digital Subtraction Angiography (DSA) is the gold standard for diagnosis and characterization.
• Imaging findings include the "double lumen" sign, indicative of a true and false lumen.

Conclusions:

• Multiple imaging modalities are available for diagnosing carotid artery dissection.
• The choice of imaging depends on clinical context, availability, and diagnostic goals.
• Advanced MRI techniques offer improved detection of intramural hematoma and dissection characteristics.