目的：应用高分辨磁共振成像分析急性脑梗死患者颈动脉粥样硬化斑块负荷及成分，并评估斑块特征与颅内新发脑梗死灶之间的关系。

方法：研究对象为2010 年—2011 年在上海交通大学医学院附属仁济医院神经内科住院的符合病例选择标准的115 例急性脑梗死患者，分析其颈动脉粥样硬化斑块负荷及成分以及新发脑梗死灶部位及体积。应用logistic 回归法分析颈动脉斑块负荷及成分与新发脑梗死灶的关系。

结果：校正常见的血管危险因素后，颈动脉粥样硬化斑块负荷与同侧颈内动脉供血区新发脑梗死灶风险及体积呈正相关（P ＜ 0.05）。平均管腔面积、平均管壁面积、管壁体积百分比、最大管壁厚度和最小管腔面积均与新发脑梗死灶体积有关，其中代表斑块负荷的平均管壁面积、管壁体积百分比和最大管壁厚度均与新发脑梗死灶体积呈正相关，代表颈动脉狭窄程度的平均管腔面积和最小管腔面积均与新发脑梗死灶体积呈负相关。颈动脉斑块内富含脂质的坏死核心、斑块内出血和斑块内钙化体积均与颈内动脉供血区新发脑梗死灶体积呈正相关（P ＜ 0.01）。

结论：颈动脉粥样硬化斑块负荷及成分与颅内新发脑梗死灶风险及体积有关。高分辨磁共振成像技术可以作为识别高危斑块的良好工具，有助于评估脑梗死发生风险。

Objective: To evaluate the relationship between carotid plaque characteristics and acute intracranial infarction lesions by analyze the carotid plaque load and composition of patients with acute intracranial infarction determined by high resolution-magnetic resonance imaging (HR-RMI).

Methods: A total of 115 eligible patients with acute cerebral infarction who were hospitalized in the Department of Neurology, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from 2010 to 2011 were enrolled. The load and composition of carotid atherosclerotic plaque and the location and volume of cerebral infarction lesions were analyzed. Logistic regression analysis was used to analyze the relationship between the load and components of carotid plaque and cerebral infarction.

Results: After adjusting for common vascular risk factors, carotid atherosclerotic plaque load was positively correlated with the risk and volume of cerebral infarction in the ipsilateral internal carotid artery supply area (P < 0.05). Mean lumen area (mean LA), mean wall area (mean WA), percent wall volume (PWV), maximum wall thickness (max WT) and minimum lumen area (min LA) were all correlated with the volume of cerebral infarction lesions. Mean WA, PWV and max WT representing plaque load were positively correlated with the volume of the infarction lesions, and the mean LA and the min LA representing the degree of carotid artery stenosis were negatively correlated with the volume of the infarction lesions. The volumes of lipid-rich necrotic core, intraplaque hemorrhage and intraplaque calcification in carotid plaque were positively correlated with the volume of cerebral infarction lesion in internal carotid artery supply area (P < 0.01).

Conclusion: The load and composition of carotid atherosclerotic plaque are related to the risk and volume of intracranial infarction. HR-MRI can be used as a good tool to identify high-risk plaques and help to assess the risk of cerebral infarction.