Purpose: We wished to evaluate the lipid-rich necrotic core (LRNC) using contrast-enhanced\nT1-weighted (CE-T1W) black-blood (BB) imaging for vessel walls. Methods: Ninety-five patients\nwith basilar artery (BA) stenosis who underwent magnetic resonance angiography between January\n2016 and August 2018 were enrolled into this present study. CE-T1W BB imaging was considered as a\nreference method for identifying an LRNC. Results: Ten (10.5%) patients were identified as having\nan LRNC on CE-T1W BB imaging. Of these patients, 9 had acute symptoms. The extent of stenosis\nin patients with an LRNC on CE-T1W BB imaging was significantly greater than that of patients\nwithout an LRNC (p < 0.001). The maximum wall thickness in patients with an LRNC on CE-T1W\nimaging was significantly thicker than that of patients without an LRNC (p = 0.008). Conclusions:\nIdentification of an LRNC on CE-T1W BB imaging was associated with high-grade stenosis and\nmassive plaque burden from BA atherosclerosis.
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