OBJECTIVE: Initial assessment of patients with suspected dissection of the carotid or vertebral arteries typically is made by MRI, alone or in combination with MR angiography (MRA) or CT angiography (CTA). We reviewed the medical literature to determine, based on test performance characteristics such as sensitivity, specificity, positive predictive value, and negative predictive value, whether evidence could be found to support routine use of one imaging technique over the other for assessment of suspected dissection. CONCLUSION: Test characteristics for MR techniques such as MRI and MRA were relatively similar to those for CTA in diagnosis of carotid and vertebral artery dissection.