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Ivy signs on FLAIR images before and after STA-MCA anastomosis in patients with Moyamoya disease

Abstract

Background: Leptomeningeal high signal intensity (ivy sign) on fluid-attenuated inversion-recovery (FLAIR) MR imaging is one of the features of Moyamoya disease. However, the correlation between ivy sign and cerebral perfusion status has not been fully evaluated. Purpose: To characterize ivy sign on FLAIR images in Moyamoya disease and compare this finding with hemodynamic alterations on perfusion single-photon emission CT (SPECT) obtained before and after bypass surgery. Material and Methods: Sixteen patients with angiographically confirmed Moyamoya disease who underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis were included in the study. The presence of ivy sign on FLAIR images was classified as 'negative', 'minimal' and 'positive'. We evaluated the relationship between ivy sign and findings of SPECT, including cerebral vascular reserve (CVR) before and after surgery. Results: Minimal or positive ivy sign was seen in 13 (81%) of 16 patients, and 21 (66%) of 32 hemispheres. CVR in the areas with positive or minimal ivy sign was lower than that in the areas with negative ivy sign. After STA-MCA anastomosis, ivy sign disappeared or decreased in all 21 hemispheres demonstrating ivy sign. SPECT demonstrated apparent hemodynamic improvement in areas demonstrating disappearance or decrease of ivy sign. Conclusion: Ivy sign on FLAIR  More>>
Authors:
Ideguchi, Reiko; Enokizono, Mikako; Uetani, Masataka; [1]  Morikawa, Minoru; [2]  Ogawa, Yoji; [3]  Nagata, Izumi [4] 
  1. Dept. of Radiological Sciences, Nagasaki Univ. Graduate School of Biomedical Sciences, Nagasaki (Japan)
  2. Dept. of Radiology, Nagasaki Univ. School of Medicine, Nagasaki (Japan)
  3. Dept. of Radiology, Hanwa Daini Senboku Hospital, Osaka (Japan)
  4. Dept. of Neurosurgery, Nagasaki Univ. School of Medicine, Nagasaki (Japan)
Publication Date:
Apr 15, 2011
Product Type:
Journal Article
Resource Relation:
Journal Name: Acta Radiologica (online); Journal Volume: 52; Journal Issue: 3; Other Information: refs., figs., tabs.; 10.1258/AR.2011.100367
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; NMR IMAGING; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY; BRAIN; SURGERY; CENTRAL NERVOUS SYSTEM
OSTI ID:
1011578
Country of Origin:
Sweden
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1600-0455; TRN: SE1108066
Availability:
Available from DOI: http://dx.doi.org/10.1258/ar.2011.100367
Submitting Site:
SWDN
Size:
page(s) 291-296
Announcement Date:
Apr 25, 2011

Citation Formats

Ideguchi, Reiko, Enokizono, Mikako, Uetani, Masataka, Morikawa, Minoru, Ogawa, Yoji, and Nagata, Izumi. Ivy signs on FLAIR images before and after STA-MCA anastomosis in patients with Moyamoya disease. Sweden: N. p., 2011. Web. doi:10.1258/AR.2011.100367.
Ideguchi, Reiko, Enokizono, Mikako, Uetani, Masataka, Morikawa, Minoru, Ogawa, Yoji, & Nagata, Izumi. Ivy signs on FLAIR images before and after STA-MCA anastomosis in patients with Moyamoya disease. Sweden. doi:10.1258/AR.2011.100367.
Ideguchi, Reiko, Enokizono, Mikako, Uetani, Masataka, Morikawa, Minoru, Ogawa, Yoji, and Nagata, Izumi. 2011. "Ivy signs on FLAIR images before and after STA-MCA anastomosis in patients with Moyamoya disease." Sweden. doi:10.1258/AR.2011.100367. https://www.osti.gov/servlets/purl/10.1258/AR.2011.100367.
@misc{etde_1011578,
title = {Ivy signs on FLAIR images before and after STA-MCA anastomosis in patients with Moyamoya disease}
author = {Ideguchi, Reiko, Enokizono, Mikako, Uetani, Masataka, Morikawa, Minoru, Ogawa, Yoji, and Nagata, Izumi}
abstractNote = {Background: Leptomeningeal high signal intensity (ivy sign) on fluid-attenuated inversion-recovery (FLAIR) MR imaging is one of the features of Moyamoya disease. However, the correlation between ivy sign and cerebral perfusion status has not been fully evaluated. Purpose: To characterize ivy sign on FLAIR images in Moyamoya disease and compare this finding with hemodynamic alterations on perfusion single-photon emission CT (SPECT) obtained before and after bypass surgery. Material and Methods: Sixteen patients with angiographically confirmed Moyamoya disease who underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis were included in the study. The presence of ivy sign on FLAIR images was classified as 'negative', 'minimal' and 'positive'. We evaluated the relationship between ivy sign and findings of SPECT, including cerebral vascular reserve (CVR) before and after surgery. Results: Minimal or positive ivy sign was seen in 13 (81%) of 16 patients, and 21 (66%) of 32 hemispheres. CVR in the areas with positive or minimal ivy sign was lower than that in the areas with negative ivy sign. After STA-MCA anastomosis, ivy sign disappeared or decreased in all 21 hemispheres demonstrating ivy sign. SPECT demonstrated apparent hemodynamic improvement in areas demonstrating disappearance or decrease of ivy sign. Conclusion: Ivy sign on FLAIR image is seen in areas with decreased cerebral perfusion. The sign is useful for non-invasive assessment of cerebral hemodynamic status before and after surgery}
doi = {10.1258/AR.2011.100367}
journal = {Acta Radiologica (online)}
issue = {3}
volume = {52}
place = {Sweden}
year = {2011}
month = {Apr}
}