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.