This study aimed to construct a radiomics-based T2-weighted imaging (T2WI) approach from high-resolution multi-contrast magnetic resonance imaging (hrMRI) in combination with clinical high-risk factors for non-invasive assessment, to differentiate symptomatic carotid atherosclerotic plaques from asymptomatic ones. Radscore showed a better diagnostic performance. The combination model of texture features and clinical data had the best performance in assessment of lesion vulnerability. This study demonstrated that hrMRI radiomics features provided incremental value for assessment of the carotid atherosclerotic vulnerability.
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