PMC9674493_01
(A) Antero-posterior projection of volume-rendering magnetic resonance (MR) angiography of the neck and (B) the source image at the level of C4-C5 intervertebral space show a normally located left internal carotid artery (ICA), posterolateral to the external carotid artery (ECA) (long and short arrows). There is mild stenosis of the right ICA at its origin (dotted arrow). The right ICA is located dorsal to the ECA (Kamide's type 2).
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The left ICA was normally located posterolateral to the left ECA (Fig. 1).
(A) Follow-up MR angiography and (B) the source image obtained 2 years later show that the left ICA moved to a location posteromedial to the ECA (long and short arrows), indicating twisted carotid bifurcation (Kamide's type 3). The right ICA is located dorsal to the ECA (dotted arrow), with no interval change.
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The left ICA was newly located posteromedial to the left ECA, indicating TCB (Fig. 2).