Evaluation of carotid atherosclerotic plaque by energy spectrum CT imaging combined with color Doppler ultrasound and its relationship with the risk of cerebral infarction

PENG Jie; WANG Qiwei; LYU Xiang; GAO Yingying; YANG Fan; WANG Liangyong

doi:10.20258/j.cnki.1006-9011.2025.10.004

Abstract：Objective To analyze the detection of carotid atherosclerotic plaque by energy spectrum CT imaging and color Doppler ultrasound,and to explore the relationship between them and the risk of cerebral infarction.Methods A retrospective study was conducted to collect the medical records of 80 patients with carotid atherosclerotic plaques admitted to the hospital.All patients received energy spectrum CT imaging and color Doppler ultrasound examination.According to the occurrence of cerebral infarction,they were divided into the occurrence group(n=27)and the non-occurrence group(n=53).The detection of carotid atherosclerotic plaques in the two groups by energy spectrum CT imaging combined with color Doppler ultrasound was compared,and the relationship between the parameters of color Doppler ultrasound and energy spectrum CT imaging and the occurrence of cerebral infarction in patients with carotid atherosclerotic plaques was analyzed.At the same time,the receiver operating curve(ROC)was drawn to evaluate its predictive value.Results The detection rate of stable plaques in the occurrence group was lower than that in the non-occurrence group,and the detection rate of unstable plaques was higher than that in the occurrence group,with statistically significant differences(P<0.05).The intima-media thickness(IMT),blood flow resistance index(RI),curve slope,and effective atomic number were higher in the occurrence group than those in the non-occurrence group.The peak systolic velocity(PSV)and peak end diastolic velocity(EDV)were lower in the occurrence group than in the non-occurrence group,with statistically significant differences(P<0.05).By point binary correlation analysis,IMT,RI,curve slope and effec-tive atomic number were positively correlated with the occurrence of cerebral infarction in patients with carotid atherosclerotic plaque(r was 0.641,0.371,0.313,0.517,P<0.05),while,PSV and EDV were negatively correlated with the occurrence of ce-rebral infarction in patients with carotid atherosclerotic plaque(r was-0.403,-0.387,P<0.05).ROC analysis showed that the AUC of energy spectrum CT imaging and color Doppler ultrasound parameters that independently predicted the occurrence of ce-rebral infarction in patients with carotid atherosclerotic plaque was more than 0.7,and the AUC of joint prediction was more than 0.9,with a higher value(P<0.05).Conclusion The combination of energy spectrum CT imaging and color Doppler ultrasound has significant value in diagnosing the stability of carotid atherosclerotic plaque,and the parameters of the two examinations are related to the occurrence of cerebral infarction in patients with carotid atherosclerotic plaque.The combination of the two param-eters can improve the clinical predictive value of the occurrence of cerebral infarction in patients with carotid atherosclerotic plaque.