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. 2021 Aug 3;12:718438. doi: 10.3389/fneur.2021.718438

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Copyright © 2021 Nies, Smits, Kassem, Nederkoorn, Oostenbrugge and Kooi.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Transversal MR images of the right internal carotid artery. The black blood pre-contrast image (A) is used to draw the contours of the lumen and outer vessel wall. The lipid-rich necrotic core shows no contrast-enhancement on the post-contrast black-blood T1w quadruple inversion recovery (QIR) turbo spin echo (TSE) image (B) and includes the entire area of hemorrhage (IPH) [IPH: blue, lipid-rich necrotic core: yellow, lumen: red, outer vessel wall: green on (C)]. IPH [blue arrow on (D)] appears as a bright signal on the inversion recovery turbo field echo images (IR-TFE; D). A thin or ruptured fibrous cap (TRFC) can be identified by the interruption of juxtaluminal signal enhancement on the post-contrast T1w image (arrow head). With a contra-indication for contrast injection the T2w image or time of flight (TOF) image (E) can be used for TRFC assessment.