Fig. 1.

a Transversal cardiovascular magnetic resonance (CMR) images of a patient with carotid plaque in the right carotid artery with intraplaque hemorrhage (IPH). The following CMR sequences were acquired: (A) pre-contrast T1-weighted (T1W) quadruple inversion recovery (QIR) turbo spin echo (TSE), (B) post-contrast T1W QIR TSE, (C) time of flight (TOF), (D) T2W TSE and (E) T1W inversion recovery (IR) turbo field echo (TFE). Three regional saturation slabs were positioned on T1W QIR TSE and T2W TSE sequences; one on the throat to reduce swallowing artefacts and another two on the subcutaneous fat, with an angle of approximately 45 degrees with respect to the regional saturation slab that is positioned on the throat (both left and right) to reduce ghosting. A lipid-rich necrotic core was identified as a region within the bulk of the plaque that does not show contrast enhancement (* on B) on the post-contrast T1W QIR images. On the T1W IR TFE image, a hyper-intense signal in the bulk of the plaque can be clearly observed, indicating the presence of IPH (* on panel E). Panel F shows the plaque contours on the post-contrast T1W QIR TSE images (green = outer vessel wall, red = inner vessel wall, yellow = lipid-rich necrotic core, blue = IPH, orange/brown = calcifications). b Transversal CMR image of a carotid plaque in the right carotid artery without IPH but with a small lipid-rich necrotic core. All panels consist of the same sequences as in Fig. 1a