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Systematic Review of Methods for Assessing Leptomeningeal Collateral Flow

Author(s): F. McVerry, D. S. Liebeskind, K. W. Muir

BACKGROUND AND PURPOSE: The importance of LMF in the outcome after acute ischemic stroke is increasingly recognized, but imaging presents a wide range of options for identification of collaterals and there is no single system for grading collateral flow. The aim of this study was to systematically review the literature on the available methods for measuring LMF adequacy. MATERIALS AND METHODS: We performed a systematic review of Ovid, MEDLINE, and Embase databases for studies in which flow in the leptomeningeal collateral vessels was evaluated. Imaging technique, grading scale, and reliability assessment for collateral flow measurement were recorded. RESULTS: We found 81 publications describing 63 methods for grading collateral flow on the basis of conventional angiography (n = 41), CT (n = 7), MR imaging (n = 9), and transcranial Doppler (n = 6). Inter- and/or intraobserver agreement was assessed in only 8 publications. CONCLUSIONS: There is inconsistency in how LMF is graded, with a variety of grading scales and imaging modalities being used. Consistency in evaluating collateral flow at baseline is required for the impact of collateral flow to be fully appreciated.

Full version: Available here

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ISBN: 0195-6108
Publication Year: 2012
Periodical: American Journal of Neuroradiology
Periodical Number: 3
Volume: 33
Pages: 576-582
Author Address: Muir, KW Univ Glasgow, So Gen Hosp, Inst Neurol Sci, Inst Neurosci & Psychol, Glasgow G51 4TF, Lanark, Scotland Univ Glasgow, So Gen Hosp, Inst Neurol Sci, Inst Neurosci & Psychol, Glasgow G51 4TF, Lanark, Scotland Univ Calif Los Angeles, UCLA Stroke Ctr, Los Angeles, CA USA