Computed tomography angiography for the evaluation of carotid artery dissections.

Catheter angiography has long been considered the standard of reference for the diagnosis of cervical artery dissection. The accuracy of magnetic resonance (MR) angiography, Doppler ultrasound or computed tomography angiography (CTA) has been evaluated in a variety of comparative clinical studies. With the development and the increasing propagation of modern multidetector CT techniques, the diagnostic potential of CTA has increased considerably. Our purpose is to summarize the technical aspects and the recent advances of CTA, and to discuss its significance for the diagnosis of cervical artery dissection. In addition the typical CTA appearance of cervical artery dissections is described, and exemplified in various clinical examples. MR angiography remains the method of choice for the exclusion of carotid artery dissection. Multidetector CTA has to be regarded as a safe and reliable diagnostic modality in the evaluation of carotid dissections. But despite its improved quality, the use of CTA in patients with suspected arterial dissection is restricted to a small number of specific indications. At present, its application is reserved for those patients presenting with contraindications to MR imaging.