Abstract: The differences of intracranial vascular plaque parameters between high-resolution magnetic resonance imaging (HR-MRI) in elderly patients with primary and recurrent cerebral infarction were compared, and the relationship between the characteristic parameters of intracranial vascular plaque and the prognosis of patients was discussed. A total of 179 elderly patients with cerebral infarction were retrospectively selected. All patients underwent HR-MRI examination before treatment. According to the cause of hospitalization, the patients were divided into primary group and recurrent group. The differences of HR-MRI intracranial vascular plaque parameters between the two groups were compared. According to the clinical outcomes, the patients were divided into good prognosis group and poor prognosis group. Univariate and multivariate Logistic regression analysis were used to analyze the relationship between HR-MRI intracranial vascular plaque parameters and other factors and the prognosis of patients with cerebral infarction. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of HR-MRI intracranial vascular plaque parameters in predicting the poor prognosis of patients with cerebral infarction. The results indicate there was no significant difference in plaque remodeling and eccentricity index between the initial and recurrent cerebral infarction groups (P>0.05). There were significant differences in intracranial vascular plaque area, plaque load, plaque hemorrhage ratio and plaque enhancement degree between the two groups (P<0.05). Univariate and multivariate results showed that recurrent cerebral infarction, infarct size, increased NIHSS score, increased plaque load, and intraplaque hemorrhage were independent influencing factors for poor prognosis in patients with cerebral infarction. The AUC of plaque burden, intraplaque hemorrhage, plaque enhancement and predictive probability based on HR-MRI in predicting the risk of poor prognosis in patients with cerebral infarction were 0.658, 0.604 and 0.616, respectively, and the specificities were 77.8%, 76.9% and 82.9%, respectively. The combined prediction AUC was 0.727, the sensitivity was 79.0%, and the specificity was 53.8%. The above findings the characteristics of intracranial vascular plaques in patients with primary and recurrent acute cerebral infarction are different. The characteristics of intracranial vascular plaques are closely related to the prognosis of patients with cerebral infarction. The characteristics of intracranial vascular plaques in cerebral infarction by HR-MRI are helpful to predict the prognosis of patients with cerebral infarction.

Key words: high-resolution magnetic resonance imaging, cerebral infarction, plaque, prognosis