目的分析MRI高分辨技术 (HRMRI)对复发性脑梗死患者颈动脉斑块 特点的诊断价值。方法 选取2015年4月至 2018年4月我院收治的脑梗死患者262例为 研究对象，其中复发性脑梗死者纳入研究 组(n=162，检出斑块165个)，初发性脑 梗死者纳入对照组(n=100，检出斑块105 个)，均于发病1周内行HRMRI检查，获得 3D-TOF、高分辨率MRI黑血序列及CE-T1WI 序列图像，对比两组所得图像，并以超微 血流成像检查为准，分析HRMRI诊断颈动 脉易损斑块的效能。结果 研究组HRMRI下 不稳定斑块检出率41.82%明显高于对照 组28.57%(P＜0.05)；研究组管壁标准化 指数(NWI)及斑块内出血(IPH)、斑块纤 维帽破裂发生率高于对照组(P＜0.05)； 以超微血流成像检查为准，HRMRI诊断复 发性脑梗死患者颈动脉易损斑块的灵敏 度、特异度、准确度、阳性预测值、阴 性预测值、kappa一致性分别为95.35%、 85.33%、88.52%、75.23%、97.52%、 0.753。结论 HRMRI可较好评估复发性脑 梗死患者颈动脉斑块性质及血管腔狭窄情 况，检出易损斑块，值得在临床推广实 践。

Objective To analyze the value of high resolution MRI (HRMRI) in the diagnosis of carotid plaque in patients with recurrent cerebral infarction. Methods A total of 262 patients with cerebral infarction who were treated in the hospital from April 2015 to April 2018 were selected as the subjects. Among them, patients with recurrent cerebral infarction were included in the study group (n=162, 165 plaques) and patients with primary cerebral infarction were included in the control group (n=100, 105 plaques). All patients underwent HRMRI within 1 week after onset, and images of 3D-TOF, highresolution MRI black blood sequence and CE-T1WI sequence were obtained. The images were compared between the two groups, and with results of ultramicro blood flow imaging examination as the standard, the efficiency of HRMRI in the diagnosis of vulnerable carotid plaque was analyzed. Results The detection rate of unstable plaques by HRMRI in the study group was significantly higher than that in the control group (41.82% vs 28.57%) (P<0.05). The normalized wall index (NWI), incidence rates of intra-plaque hemorrhage (IPH) and fibrous cap rupture in the study group were higher than those in the control group (P<0.05). With results of ultramicro blood flow imaging examination as the standard, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and kappa consistency of HRMRI in the diagnosis of vulnerable carotid plaque in patients with recurrent cerebral infarction were 95.35%, 85.33%, 88.52%, 75.23%, 97.52% and 0.753, respectively. Conclusion HRMRI can better evaluate the nature of carotid plaques and the state of vascular stenosis in patients with recurrent cerebral infarction and detect vulnerable plaques.