Article Data

  • Views 2201
  • Dowloads 194

Original Research

Open Access

Assessment of leptomeningeal collateral status using single-phase computed tomography angiography and its clinical value

  • Liming Cao1,2,*,†
  • Lijie Ren1,2,†
  • Hongliang Jiang3,†
  • Jiahua Li2,4
  • Guozhen Qiu5
  • Feng Chi1,2

1Department of Neurology, The First Affiliated Hospital of Shenzhen University, 518000 Shenzhen, Guangdong, China

2Department of Neurology, Shenzhen Second People's Hospital, 518000 Shenzhen, Guangdong, China

3Department of Neurology, The Third People’s Hospital of Yiyang City, 413001 Yiyang, Hunan, China

4Department of Medicine, Shenzhen University, 518060 Shenzhen, Guangdong, China

5Department of Neurology, The Third Affiliated Hospital of Shenzhen University, 518001 Shenzhen, Guangdong, China

DOI: 10.22514/sv.2021.234 Vol.19,Issue 1,January 2023 pp.130-135

Submitted: 31 August 2021 Accepted: 12 October 2021

Published: 08 January 2023

*Corresponding Author(s): Liming Cao E-mail: caolm-2007@163.com

† These authors contributed equally.

Abstract

At present, there is a lack of consensus regarding the high-cost performance method for evaluating the leptomeningeal collateral (LMC) status, and there are only few reports on the relationship between the LMC status and short-term neurological improvements in patients with acute middle cerebral artery (MCA) stroke. To evaluate the LMC status using single-phase computed tomography angiography (CTA) and assess the effect of the LMC status on short-term outcomes in patients with acute MCA regional ischemic stroke without reperfusion therapy. Thirty patients with acute MCA regional ischemic stroke without reperfusion therapy were sampled prospectively. Then, 256-layer single-phase CTA (using enhanced computed tomography, maximal intensity projection technology and multi-plane volume reconstruction) was used to measure each patient’s LMC status using the MCA regional collateral score. The correlation between the LMC status and changes in the National Institutes of Health Stroke Scale (NIHSS) score was assessed. Differences in the modified Rankin scale score at 3 months after discharge between patients with a good (MCA territory collateral score ≥2) and those with a poor (MCA territory collateral score 0–1) LMC status were assessed. The NIHSS score change between admission and discharge correlated with the LMC status at admission (r = 0.88, p = 0.03). Three months after discharge, the mean modified Rankin scale scores in the poor and good LMC status groups were 1.91 ± 1.65 and 1.03 ± 1.36, respectively (p = 0.0394). The NIHSS scores at 3 months after discharge in the poor and good LMC status groups were 4.31 ± 4.29 and 2.16 ± 2.06, respectively (p = 0.0489). Our findings can further reinforce the understanding of the appropriate assessment of LMCs and its clinical value. A 256-slice single-phase CTA-maximal intensity projection can provide good assessment of the LMC status. In patients with MCA regional acute ischemic stroke, the LMC status may predict the short-term prognosis. Further research is needed to confirm these findings.


Keywords

Middle cerebral artery; Leptomeningeal collateral status; Modified Rankin scale score; Computed tomography angiography; Ischemic stroke


Cite and Share

Liming Cao,Lijie Ren,Hongliang Jiang,Jiahua Li,Guozhen Qiu,Feng Chi. Assessment of leptomeningeal collateral status using single-phase computed tomography angiography and its clinical value. Signa Vitae. 2023. 19(1);130-135.

References

[1] Murray CJL, Lopez AD. Measuring the global burden of disease. The New England Journal of Medicine. 2013; 369: 448–457.

[2] Leng X, Lan L, Liu L, Leung TW, Wong KS. Good collateral circulation predicts favorable outcomes in intravenous thrombolysis: a systematic review and meta-analysis. European Journal of Neurology. 2016; 23: 1738–1749.

[3] Madelung CF, Ovesen C, Trampedach C, Christensen A, Havsteen I, Hansen CK, et al. Leptomeningeal collateral status predicts outcome after middle cerebral artery occlusion. Acta Neurologica Scandinavica. 2018; 137: 125–132.

[4] Tan BY, Kong WY, Ngiam JN, Teoh HL, Sharma VK, Yeo LL. The Role of Topographic Collaterals in Predicting Functional Outcome after Thrombolysis in Anterior Circulation Ischemic Stroke. Journal of Neuroimaging. 2017; 27: 217–220.

[5] Chuang Y, Chan L, Lai Y, Kuo K, Chiou Y, Huang L, et al. Configuration of the circle of Willis is associated with less symptomatic intracerebral hemorrhage in ischemic stroke patients treated with intravenous throm-bolysis. Journal of Critical Care. 2013; 28: 166–172.

[6] Branch of Cerebral Blood Flow and Metabolism, Chinese Stroke Society. The Chinese guidelines for the evaluation and management of cerebral collateral circulation in ischemic stroke. Chinese Journal of Internal Medicine. 2017; 56: 460–471. (In Chinese)

[7] Li QL, Yang DY, Liu B, Li Z. Imaging evaluation of collateral circulation of cerebral blood supply. Chinese Journal of Stroke. 2015; 10: 175–180.(In Chinese)

[8] Ma R, Bai X, Yu X, Du Q. Analysis of factors related to collateral circulation opening in patients with middle cerebral artery stenosis and its impact on prognosis. Ningxia Medical Journal. 2014; 36: 317–319.(In Chinese)

[9] Xu P, Liu Z, Han G, Zhou H, Wei S. Study on the correlation between leptomeningeal collaterals circulation and cerebral nerve function in patients with middle cerebral artery M1 occlusion. Acta Academiae Medicinae Weifang. 2016; 38: 84–86. (In Chinese)

[10] Society of Neurology of Chinese Medical Association, Cerebrovascular Disease Group of Society of Neurology, Chinese Medical Association. Guidelines for the diagnosis and treatment of acute ischemic stroke in China 2014. Chinese Journal of Neurology. 2015; 48: 246–257. (In Chinese)

[11] Chen MS, Xing G. Preliminary study of optimizing post-processing pa-rameters of CTA-MIP for visualizing middle cerebral artery. International Journal of Medical Radiology. 2019; 42: 26–31. (In Chinese)

[12] Tan IYL, Demchuk AM, Hopyan J, Zhang L, Gladstone D, Wong K, et al. CT angiography clot burden score and collateral score: correlation with clinical and radiologic outcomes in acute middle cerebral artery infarct. American Journal of Neuroradiology. 2009; 30: 525–531.

[13] Jung S, Wiest R, Gralla J, McKinley R, Mattle H, Liebeskind D. Relevance of the cerebral collateral circulation in ischaemic stroke: time is brain, but collaterals set the pace. Swiss Medical Weekly. 2017; 147: w14538.

[14] Liu SX. Development and variation of Willis ring in patients with cerebrovascular ischemic disease. Anhui Medical Journal. 2012; 33: 877–881. (In Chinese)

[15] Mangiafico S, Saia V, Nencini P, Romani I, Palumbo V, Pracucci G, et al. Effect of the Interaction between Recanalization and Collateral Circu-lation on Functional Outcome in Acute Ischaemic Stroke. Interventional Neuroradiology. 2014; 20: 704–714.

[16] Brunner F, Tomandl B, Hanken K, Hildebrandt H, Kastrup A. Impact of collateral circulation on early outcome and risk of hemorrhagic complications after systemic thrombolysis. International Journal of Stroke. 2014; 9: 992–998.

[17] Sun Y, Wei W, Li Y, Zhang WW, Zhu GM. Collateral flow score based on CTA-MIP Imaging to investigate the clinical outcome of acute cerebral infarction with occlusion of middle cerebral artery. Journal of Apoplexy and Nervous Diseases. 2014; 31: 196–199. (In Chinese)

[18] Frölich AM, Wolff SL, Psychogios MN, Klotz E, Schramm R, Wasser K, et al. Time-resolved assessment of collateral flow using 4D CT angiography in large-vessel occlusion stroke. European Radiology. 2014; 24: 390–396.

[19] Galego O, Jesus-Ribeiro J, Baptista M, Sargento-Freitas J, Martins AI, Silva F, et al. Collateral pial circulation relates to the degree of brain edema on CT 24 hours after ischemic stroke. The Neuroradiology Journal. 2018; 31: 456–463.

[20] Ribo M, Flores A, Rubiera M, Pagola J, Sargento-Freitas J, Rodriguez-Luna D, et al. Extending the Time Window for Endovascular Procedures According to Collateral Pial Circulation. Stroke. 2011; 42: 3465–3469.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top