Qualitative Assessment and Reporting Quality of Intracranial Vessel Wall MR Imaging Studies: A Systematic Review

Abstract

Background: Over the last quarter-century, the number of publications using vessel wall MR imaging has increased. Although many narrative reviews offer insight into technique and diagnostic applications, a systematic review of publication trends and reporting quality has not been conducted to identify unmet needs and future directions.

Purpose: We aimed to identify which intracranial vasculopathies need more data and to highlight areas of strengths and weaknesses in reporting.

Data sources: PubMed, EMBASE, and MEDLINE databases were searched up to September 2018 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data analysis: Two independent reviewers screened and extracted data from 128 articles. The Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used to assess the reporting quality of analytic observational studies.

Data synthesis: There has been an exponentially increasing trend in the number of vessel wall MR imaging publications during the past 24 years (P < .0001). Intracranial atherosclerosis is the most commonly studied intracranial vasculopathy (49%), followed by dissections (13%), aneurysms (8%), and vasculitis (5%). Analytic observational study designs composed 48% of the studies. Transcontinental collaborations showed nonsignificantly higher reporting quality compared with work originating from single continents (P = .20).

Limitations: A limitation is the heterogeneity in study designs.

Conclusions: Investigations on the diagnostic utility of vessel wall MR imaging in less commonly studied intracranial vasculopathies such as dissections, aneurysms, and vasculitis are warranted. More consistent adherence to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines should improve transparency and maximize effective synthesis for clinical translation. Diverse collaborative teams are encouraged to advance the understanding of intracranial vasculopathies using vessel wall MR imaging.

Fig 1.

Systematic review of the data bases. From the initial data base search, 165 articles were identified for full-text review. Manual review of the citations of those 165 articles identified 807 citations that were further screened by title and abstract. This resulted in 69 articles for full-text review from the manual citation search. A total of 234 articles underwent full-text review, from which 128 articles met the predetermined inclusion and exclusion criteria.

Fig 2.

Annual number of publications using vessel wall MR imaging.

Fig 3.

Distribution of publications by funding source, continent and intracranial vasculopathy. A, Distribution of publications by continent is shown. Distribution of transcontinental collaborations is further elaborated to show 4 different groups of collaborating partners. B, Distribution of different funding sources and the combination of funding sources are shown. C, Distribution of studied intracranial vasculopathies are shown. RCVS indicates reversible cerebral vasoconstriction syndrome.