This thesis investigates the role of intraplaque hemorrhage (IPH) in carotid atherosclerosis as a predictor of stroke risk. Approximately 15% of transient ischemic attacks and ischemic strokes are associated with carotid plaques, with clinical decision-making traditionally focused on stenosis severity. Recent studies have highlighted the importance of plaque composition, particularly IPH, in assessing stroke risk. However, the factors contributing to IPH development remain poorly understood, and the effects of antiplatelet therapy on IPH have not been thoroughly studied. The thesis examines changes in IPH volume over a two-year period in stroke patients with symptomatic carotid plaques, exploring the relationship between IPH and plaque characteristics like fibrous cap rupture and plaque surface features. It also evaluates the diagnostic accuracy of detecting IPH using routine MRI sequences and introduces the novel Multi-contrast Atherosclerosis Characterization (MATCH) sequence for improved plaque assessment. The findings aim to enhance the understanding the role of IPH in stroke risk and inform clinical imaging practices.

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