Diagnostic value of head and neck CT angiography in carotid plaque in patients with cerebral infarction

[Abstract] Objective To research the diagnostic utility of head and neck CT angiography in cerebral infarction patients with carotid plaque. Methods Eighty patients who were admitted to our hospital with a diagnosis of cerebral infarction from January 2019 through December 2021 were chosen to participate in the study. Both digital subtraction angiography and computed tomography angiography of the head and neck were performed on all patients. By using DSA as the gold standard for diagnosis, the receiver operating characteristic (ROC) curve was used to assess the diagnostic value of head and neck CTA for carotid plaque in cerebral infarction patients. The diagnostic results of carotid plaques, their distribution, and their characteristics were observed in patients with cerebral infarction by head and neck CTA. Results DSA showed that among the 80 patients with cerebral infarction, 48 (60.00%) had carotid plaques, 32 (40.00%) had no carotid plaques; 172 carotid plaques, including common carotid artery 52 (30.23%), internal carotid artery 64 (37.21%), and external carotid artery 56 (32.56%); 172 carotid plaques, including 83 soft plaques (48.26%), 37 mixed plaques (21.51%), 52 hard plaques (30.23%). Taking DSA as the diagnostic gold standard, a total of 36 cases (45.00%) of carotid plaques were diagnosed by head and neck CTA, 44 cases (55.00%) without carotid plaques, 4 cases (5.00%) were misdiagnosed, and 15 cases (18.75%) were missed, the coincidence rate of diagnosing carotid plaque was 76.25% (61/80), and the Kappa value of DSA was 0.750; Plaque distribution in the carotid arteries was not significantly different between DSA and head and neck CTA (P > 0.05); When comparing the diagnostic accuracy of DSA with head and neck CTA for identifying carotid plaque characteristics, there was no statistically significant difference (P > 0.05). Patients with cerebral infarction who undergo head and neck CTA diagnosis of carotid plaque had sensitivity of 68.75% (33/48), specificity of 87.50% (28/32), accuracy of 76.25% (61/80), positive predictive value of 91.67% (33/36), and negative predictive value of 63.64% (28/44), area under the ROC curve (AUC) of 0.812, and 95% confidence interval (CI) of 0.752–0.903. Conclusion Carotid plaque may be accurately identified in patients with cerebral infarction using head and neck CTA, which also identifies its precise distribution and type. This information is crucial for the clinical diagnosis and management of cerebral infarction.