Evaluation of head and neck CTA and serum Hcy,UA on carotid atherosclerosis in patients with cerebral infarction

MA Ying; CHEN Guozhi; CHEN Beilei

doi:10.20258/j.cnki.1006-9011.2025.01.004

Abstract：Objective To explore the evaluation effect of head and neck CT angiography(CTA),serum homocysteine(Hcy)and uric acid(UA)on carotid atherosclerosis in patients with cerebral infarction.Methods A study was conducted on 70 cerebral infarction patients admitted to our hospital's Department of Neurology.All 70 patients underwent head and neck CT angiography(CTA)using Siemens'third-generation dual-source CT scanner with scan parameters set at a tube current of 300 mA,tube voltage of 120 kV,and slice thickness of 0.5 mm.Iodixanol[specification:15 g(I)/50 ml/vial]was administered at a rate of 45～50 ml at 4.5～5.0 ml/s,scanning from the bottom up from the patient's aortic arch to the intracranial arteries.The im-ages were processed with subtraction software to record the luminal stenosis.In conjunction with the numerical changes of homo-cysteine(Hcy)and uric acid(UA)in the 70 patients,a correlation analysis of carotid atherosclerosis was performed.Result The CTA findings were statistically different from the gold standard by digital subtraction angiography(DSA).(Kappa value=0.722,P<0.05).Univariate analysis showed that there were statistical differences between Hcy and UA in severe,moderate,mild and no stenosis(P<0.05),with Hcy and UA in no stenosis that were significantly lower than those of severe,moderate and mild patients(P<0.05).Kendall analysis showed that the degree of stenosis was positively associated with Hcy and UA;ROC curve analysis showed that the AUC of serum Hcy,UA and patients without stenosis was 0.854,0.747 and 0.922,and the sensi-tivity and specificity of the two were 88.9%and 86.9%.Conclusion The predictive and diagnostic value of CTA examination for carotid atherosclerosis in patients with cerebral infarction is relatively general,and the predictive value of Hcy and UA index lev-els is better.