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Original ArticleOpen Access
Straight Artery Sign in Extracranial Carotid Artery Dissection Nijasri C.
S 
,
Phanthumchinda K ,
Suwanwela N
,
Phanthumchinda K ,
Suwanwela N NIJASRI C. SUWANWELA, MD*,
KAMMANT PHANTHUMCHINDA, MD*,
NITA YA SUWANWELA, MD**
Background and Purpose : Magnetic resonance imaging (MRI) has become generally
accepted as a non-invasive method to provide the definitive diagnosis of cervicocerebral vessel dis-
section. The finding of an intramural hematoma on axial MR images is the characteristic sign of the
disease. However, there has been no previous report of the characteristic magnetic resonance angio-
graphic (MRA) findings.
Method : The authors retrospectively reviewed MRI and MRA findings of patients with
spontaneous extracranial carotid dissection. The most striking finding on MRA was the straightness of
the affected artery when compared to the non-affected side of the same patient. For quantitative mea-
surement, "Carotid Straightness Index (CSI)" was developed to measure the straightness of the arteries
and compared the indices of both extracranial internal carotid arteries in the same patient.
Results: The patients' age range was from 21-55 years (mean 38 years). There were 6 males
and 3 females. All patients had the classical "Straight artery sign" on the MRA. The carotid straight-
ness index was significantly higher in the affected artery when compared to the normal side of the same
patient.
Conclusion : The straight artery sign and the carotid straightness index can be very useful for
early detection of the extracranial carotid dissection. It can be found in early stage disease or in less
severe forms of carotid dissection where significant narrowing is not demonstrated.
Key word : Carotid Dissection, MRA, Carotid Straightness Index
KAMMANT PHANTHUMCHINDA, MD*,
NITA YA SUWANWELA, MD**
Background and Purpose : Magnetic resonance imaging (MRI) has become generally
accepted as a non-invasive method to provide the definitive diagnosis of cervicocerebral vessel dis-
section. The finding of an intramural hematoma on axial MR images is the characteristic sign of the
disease. However, there has been no previous report of the characteristic magnetic resonance angio-
graphic (MRA) findings.
Method : The authors retrospectively reviewed MRI and MRA findings of patients with
spontaneous extracranial carotid dissection. The most striking finding on MRA was the straightness of
the affected artery when compared to the non-affected side of the same patient. For quantitative mea-
surement, "Carotid Straightness Index (CSI)" was developed to measure the straightness of the arteries
and compared the indices of both extracranial internal carotid arteries in the same patient.
Results: The patients' age range was from 21-55 years (mean 38 years). There were 6 males
and 3 females. All patients had the classical "Straight artery sign" on the MRA. The carotid straight-
ness index was significantly higher in the affected artery when compared to the normal side of the same
patient.
Conclusion : The straight artery sign and the carotid straightness index can be very useful for
early detection of the extracranial carotid dissection. It can be found in early stage disease or in less
severe forms of carotid dissection where significant narrowing is not demonstrated.
Key word : Carotid Dissection, MRA, Carotid Straightness Index
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