Computed tomographic angiography of carotid artery stenosis

Computerized tomography angiography (CTA) is increasingly used in the diagnosis of carotid artery stenosis, along with other noninvasive tests such as duplex ultrasound (DUS) or magnetic resonance angiography (MRA). The use of intravenous iodinated contrast in CTA allows excellent images of the lumen of the arteries. CTA visualizes the wall of the arteries and the morphology of the atherosclerotic plaque. Each of the different postprocessing techniques used to construct a 3D angiographic display of the artery have their particular strengths and weaknesses in imaging carotid artery stenosis. Maximum intensity projection (MIP) reconstructions are often used in CTA because they can rapidly automatically be generated. The projection, lateral, posteroanterior, or oblique, which shows the most severe stenosis, is used for establishing the degree of stenosis. Multislice CT-scanning together with other technical developments will probably further improve the diagnostic accuracy of CTA.