Zhou T, Jia S, Wang X, et al. - A total of 696 patients from 20 articles were analyzed in order to examine the diagnostic performance of MRI in diagnosing carotid atherosclerotic intraplaque hemorrhage (IPH) and to give a clinical guide for MRI application. The sensitivity and specificity, respectively, were 87% and 92%. The positive and negative likelihood ratios, respectively, were 10.27 and 0.15. The area under the summary receiver-operating characteristic curve was 0.95. In verifying or in ruling out disease over a wide range of pretest probabilities of IPH, MRI was correct, ie, in patients with a pretest probability > 27%, MRI could enhance the posttest probability to > 80% and could reduce the posttest probability to < 20% in patients with a pretest probability < 64%. Thus, for diagnosing IPH, non-invasive MRI has superior specificity and good sensitivity. Moreover, MRI is a tool for validating or ruling out carotid atherosclerotic IPH.