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. 2022 Oct 4;33(2):1088–1101. doi: 10.1007/s00330-022-09025-6

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© The Author(s) 2022, corrected publication 2022

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Fig. 6 — Intraplaque hemorrhage (IPH) demonstrated on MR in a 74-year-old man with a left-sided stroke. This case of intraplaque hemorrhage clearly demonstrates the T1-shortening effect of methemoglobin generated from erythrocyte degradation, illustrated as an intralesional hyperintense signal (arrows in a, b) in the left internal carotid artery (asterisk in a), as shown in CUBE (a) and MPRAGE-sequences (b). For additional evaluation of luminal repercussion, a contrast-enhanced MR angiography sequence was executed, revealing a severe luminal narrowing with a focal ulceration (arrow in c). The presence of plaque ulceration and intraplaque hemorrhage are two important features in this case that provide additional clinically and prognostically relevant information on top of the mentioned luminal narrowing. CUBE: General Electric proprietary name for a 3D fast spin echo sequence; MPRAGE: magnetization-prepared 180° radio-frequency pulses and rapid gradient echo