Objective:To analyze the correlation between the degree of internal carotid artery tortuosity and plaque burden through dual-source computed tomography (CT),and to further investigate the relationship between the internal carotid artery tortuosity and the formation of cerebral infarction. Methods:A total of 106 patients with internal carotid artery tortuosity,who underwent computed tomography angiography (CTA) examination on head and neck at the First People's Hospital of Lianyungang from December 2021 to December 2022,were retrospectively selected. The patients were divided into a cerebral infarction group and a non-cerebral infarction group based on cranial magnetic resonance imaging (MRI) examination,with 53 cases in each group. The internal carotid artery tortuosity-related indicators (tortuosity index,degree of vascular deviation,vascular tortuosity),and the parameters of plaque characteristic (plaque area,vascular area and plaque burden) between the two groups were compared. Univariate and multivariate analyses were used,and the information of age,gender,history of underlying disease (such as hypertension,diabetes,coronary heart disease,etc.),lifestyle habits (such as smoking,drinking),and stroke history of patients in both groups were collected. Clinical biochemical indicators included triglycerides,total cholesterol,low-density lipoprotein,high-density lipoprotein,lipoprotein a,and homocysteine. Independent risk factors of affecting plaque burden and cerebral infarction were explored. Pearson correlation analysis was used to examine the correlation between the indicators of internal carotid artery tortuosity and plaque burden of the patients,as well as the relationship between the carotid artery tortuosity and the formation of cerebral infarction. The receiver operating characteristic (ROC) curve was used to assess the predictive ability of indicators of patients for cerebral infarction. Results:The index of internal carotid artery tortuosity,degree of vascular deviation,plaque burden,plaque area,and degree of carotid artery stenosis were significantly positively correlated with cerebral infarction (r=0.310,0.203,0.345,0.320,0.292,P<0.05),respectively. ROC curve analysis showed that the area under curve (AUC) values of tortuosity index and plaque burden were respectively 0.679 and 0.677 in predicting cerebral infarction. The AUC value of combined indicator (tortuosity index+plaque burden) was 0.806 in predicting cerebral infarction,which was significantly higher than that of single indicator that was singly used (95%CI:0.722-0.89,P<0.01). Conclusion:There are significant correlation between the degree of internal carotid artery tortuosity,plaque burden,and formation of cerebral infarction. The combined use of the tortuosity index and plaque burden can significantly improve the predictive accuracy for cerebral infarction.