Diagnostic value of CTA combined with serum TNF-α and IFN-γ for carotid plaques in ischemic stroke patients

doi:10.3969/j.issn.1004-583X.2026.01.006

Abstract

Abstract:

Objective To evaluate the diagnostic value of computed tomography angiography (CTA) combined with serum tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) for detecting carotid artery plaques in patients with ischemic stroke. Methods From January 1 to December 31, 2024, sixty-nine consecutive ischemic stroke inpatients treated in the Department of Neurology at Jiangsu Shengze Hospital were enrolled as the observation group; sixty-six contemporaneous healthy examinees served as controls. All patients underwent both digital subtraction angiography (DSA) and CTA; CTA findings were compared with DSA to assess diagnostic performance. Serum TNF-α and IFN-γ levels were measured in both groups. Based on the DSA results, the patient cohort was divided into plaque-positive (n=44) and plaque-negative (n=25) subgroups. TNF-α and IFN-γ levels were compared between subgroups. A diagnostic model combining CTA with serum TNF-α and IFN-γ was constructed and its performance evaluated by receiver operating characteristic (ROC) curve analysis. Results CTA identified carotid plaques in 43 of 69 ischemic stroke patients (62.3%). Versus DSA, CTA demonstrated sensitivity 93.2%, specificity 92.0%, positive predictive value 95.3%, negative predictive value 88.5%, and overall diagnostic accuracy 92.8%. Serum TNF-α and IFN-γ were significantly higher in ischemic stroke patients than in healthy controls (P<0.05), and levels were significantly greater in the plaque-positive subgroup compared with the plaque-negative subgroup (P<0.05). The combined CTA+TNF-α+IFN-γ diagnostic model showed excellent discrimination (area under the ROC curve [AUC]=0.966) with high sensitivity and specificity (P<0.05); the model’s high specificity indicates particular value for excluding patients without carotid plaque. Conclusion A multimodal diagnostic approach that integrates CTA imaging with serum TNF-α and IFN-γ measurements provides high sensitivity and specificity for detecting carotid plaques in patients with ischemic stroke. By combining anatomical localization from imaging with biomarker-based biological characterization, this strategy offers a more comprehensive basis for vascular risk stratification in ischemic stroke patients.

Key words: brain infarction, computed tomography angiography, tumor necrosis factor-alpha, interferon-gamma, carotid artery plaques

CLC Number:

R743.33

Lu Minyan, Zhou Li, Qi Zhiqiang, Lu Yang. Diagnostic value of CTA combined with serum TNF-α and IFN-γ for carotid plaques in ischemic stroke patients[J]. Clinical Focus, 2026, 41(1): 38-43.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.01.006

https://www.lchc.cn/EN/Y2026/V41/I1/38

Figures/Tables 8

References 26

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CTA检查	DSA检查(例)		合计
CTA检查	有斑块	无斑块	合计
有斑块	41	2	43
无斑块	3	23	26
合计	44	25	69

CTA检查	DSA检查(例)		合计
CTA检查	有斑块	无斑块	合计
有斑块	41	2	43
无斑块	3	23	26
合计	44	25	69

组别	例数	女性 [例(%)]	年龄 (岁)	高血压 [例(%)]	糖尿病 [例(%)]	TNF-α (ng/L)	IFN-γ (ng/L)
对照组	66	20(30.3)	67.30±12.02	51(77.3)	25(37.9)	1.07(0.57, 1.98)	3.01(0.88, 7.80)
观察组	69	19(27.5)	63.77±11.89	52(75.4)	24(34.8)	1.78(1.24, 2.90)	4.41(2.79, 7.57)
χ²/t/Z值		0.126	1.718	0.068	0.14	-3.405	-2.67
P值		0.723	0.088	0.794	0.708	0.001	0.008

组别	例数	女性 [例(%)]	年龄 (岁)	高血压 [例(%)]	糖尿病 [例(%)]	TNF-α (ng/L)	IFN-γ (ng/L)
对照组	66	20(30.3)	67.30±12.02	51(77.3)	25(37.9)	1.07(0.57, 1.98)	3.01(0.88, 7.80)
观察组	69	19(27.5)	63.77±11.89	52(75.4)	24(34.8)	1.78(1.24, 2.90)	4.41(2.79, 7.57)
χ²/t/Z值		0.126	1.718	0.068	0.14	-3.405	-2.67
P值		0.723	0.088	0.794	0.708	0.001	0.008

组别	例数	TNF-α(ng/L)	IFN-γ(ng/L)
斑块阴性亚组	25	1.16(0.51, 1.78)	3.56(1.24, 5.07)
斑块阳性亚组	44	2.00(1.56, 4.03)	5.09(3.87, 8.52)
Z值		-3.84	-3.223
P值		<0.001	0.001