Examination of the extracranial carotid bifurcation by thin-section dynamic CT: direct visualization of intimal atheroma in man (Part 1).

Because carotid angiography has been shown to have limitations in the detection of intimal disease at the bifurcation, a new method of examination of the extracranial carotid artery has been developed using thin-section dynamic computed tomographic (CT) scanning. Carotid atheroma and thrombi can be imaged directly on these sections. The intimal lesions are uniformly hypodense with respect to the carotid arterial wall. Radiologic-pathologic correlation studies using human carotid arteries in a neck phantom confirm that these hypodense lesions are atheromas or thrombi. There is good correlation between CT cross-sectional images and cross-sectional postmortem artery sections. While a number of new computer-based methods of reformation of the carotid artery have been developed, consecutive thin slices through the carotid bifurcation display the pathologic lesions satisfactorily.