Axial images show a large eccentric plaque in the left common carotid artery of a 53-year old patient. The arrow points to an area of high signal intensity on TOF and T1w images which indicates intraplaque hemorrhage. Post-contrast T1w images allow the delineation of the lipid-rich necrotic core, which does not show any contrast uptake. The lipid-rich necrotic core is covered by a layer of fibrous tissue, which is hyperintense on the PDw and T2w images, consistent with an intact fibrous cap. The plaque is classified as a complicated American Heart Association Lesion Type VI.