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Common carotid artery

The common carotid artery (CCA) is a major paired artery in the neck, essential for supplying oxygenated blood to the head and neck. It originates differently on each side: the right arises from the brachiocephalic trunk, while the left arises directly from the aortic arch. Each CCA travels upward in the neck and divides at the level of the upper border of the thyroid cartilage into the internal and external carotid arteries. The CCA is a key structure in clinical and radiological practice, particularly for vascular, neurological, and surgical evaluations.

Synonyms

  • CCA

  • Arteria carotis communis

  • Common carotid trunk

  • Main carotid artery

Function

  • Supplies oxygenated blood to the head and neck regions

  • Main arterial conduit for the brain (via internal carotid artery branch)

  • Supplies face and scalp (via external carotid artery branch)

  • Critical in cerebral and extracranial perfusion

  • Central in monitoring for atherosclerosis, stroke risk, and vascular pathologies

MRI Appearance

  • T1-Weighted Images

    • CCA lumen appears intermediate to low signal intensity

    • Flow void phenomenon commonly observed due to fast-moving blood

    • Vessel wall may appear slightly hyperintense if atherosclerotic changes or wall thickening exist

  • T2-Weighted Images

    • Lumen typically dark/low signal (flow void)

    • Surrounding soft tissues (muscle, fat) provide contrast

    • Wall abnormalities (plaque, thrombus) may be hyperintense

  • STIR (Short Tau Inversion Recovery) Sequence

    • Blood flow remains dark/low signal (flow void)

    • STIR suppresses fat, highlighting vessel wall pathology, edema, or inflammatory changes

    • Useful for identifying vessel wall thickening, peri-vascular edema, or inflammation

  • TOF (Time of Flight) MR Angiography

    • CCA shows as a bright/high signal structure

    • Relies on inflow effect; normal, patent artery appears bright

    • Useful for detecting stenosis, occlusion, or dissection

    • High sensitivity for flow-related pathology

CT Appearance

  • Non-contrast CT

    • CCA seen as a round/oval structure in neck, adjacent to internal jugular vein

    • Lumen is generally isodense with blood

    • Vessel wall not well delineated unless calcified

    • Plaques and wall calcifications can be seen as hyperdense regions

  • CTA (CT Angiography)

    • After contrast injection, CCA lumen appears bright/enhanced

    • High-resolution delineation of arterial lumen, wall, and branches

    • Excellent for detecting stenosis, plaques, aneurysms, dissections

    • Can assess vessel wall thickness, irregularities, and atheromatous changes

    • Multiplanar and 3D reconstructions available for surgical or interventional planning

MRI images

Common carotid artery axial t2

MRI images

Common carotid artery coronal t2 image

CT image

Common carotid artery CT axial image-img-00000-00000