Figure 2

Shows axial TOF, T1 weighted pre and post contrast and T2 weighted high-resolution black-blood CMR and CTA (lower right) images of a plaque in the left internal carotid artery of a patient with an acute ischemic stroke on the left side. While both CMR and CT images fail to show a distinct surface defect, the fibrous cap is not entirely distinguishable and was therefore by definition classified as thin. The hyperintense signal within the plaque in TOF and T1 weighted images in combination with hypointense signal in the T2 weighted image corresponds to an intraplaque hemorrhage (arrowhead). The relative lack of contrast enhancement within the plaque indicates the presence of a lipid-rich necrotic core (arrow). Correspondingly, the CTA image shows a relatively hypodense plaque interior (mean plaque density =65,1 HU). The hyperdense area in the dorsal wall of the plaque corresponds to a hypointense signal in the MR images and is consistent with a marginal calcification. * Sternocleid muscle