Figure 4

Two illustrative cases of potentially culprit plaques. (A) In a 62-year-old male with abrupt dysarthria and pontine infarct, only mild distal basilar stenosis was identified on MR angiography. (B) Conv-VWI revealed the plaque with punctate T1WI hyperintensity, which was interpreted as an intraplaque hemorrhage (IPH) by only one reviewer. (C) DL-VWI more clearly depicts the apparent T1WI hyperintensity and positive remodeling. (D) Another 66-year-old male presented with abrupt left homonymous hemianopia, showing right posterior cerebral artery territory infarct with focal distal stenosis. (E) Same as Fig. 1, the signal of the plaque in Conv-VWI was misinterpreted as image noise by both reviewers. (F) DL-VWI provides a clearer depiction of the presence of IPH.