Computed tomography angiography (CTA) of carotid arteries is a standardized procedure with excellent image quality but related with high radiation exposure. Modern imaging studies like CTA and MRI allow to obtain three-dimensional reconstruction of anatomic structures and pathological abnormalities. While digital subtraction angiography (DSA) is still considered the gold standard, it has increasingly been replaced by computed tomography angiography (CTA) or magnetic resonance angiography (MRA) during the last years. Digital subtraction angiography (DSA) has assumed a major role in the evaluation of occlusive cerebrovascular disease. It assesses blood flow in the carotid arteries, measures the speed of the blood flow, and estimates the diameter of a blood vessel and degree of obstruction. As initial screening study, the radiologists recommend DUS. It is a safe and painless way to produce pictures of the inside of the body using sound waves. The goal of the diagnostic imaging is to provide screening and to detect diseases at its earliest and most treatable stage. The diagnostic modalities that are used to image the carotid artery diseases are digital subtraction angiography (DSA), duplex ultrasound (DUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). In the study of carotid arteries, the different imaging techniques allow to analyze various diseases like stenoses, aneurysms, thromboses, dissections, diseases caused by atherosclerotic plaques or congenital abnormalities.
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