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Case Reports
. 1999 Nov-Dec;20(10):1836-8.

"Ivy sign" on fluid-attenuated inversion-recovery images in childhood moyamoya disease

M Maeda  1 , C Tsuchida
Affiliations
Case Reports

"Ivy sign" on fluid-attenuated inversion-recovery images in childhood moyamoya disease

M Maeda et al. AJNR Am J Neuroradiol. 1999 Nov-Dec.

Abstract

We report on MR studies of a 15-year-old girl with moyamoya disease in whom diffuse leptomeningeal enhancement ("ivy sign") was revealed by fluid-attenuated inversion-recovery (FLAIR) and contrast-enhanced imaging. We speculate that the mechanism behind this enhancement is caused by a retrograde slow flow of engorged pial vasculature via leptomeningeal anastomosis. Nevertheless, it remains unknown whether the precise source of a high signal on FLAIR images is attributable to pial vessels themselves or congested thickening of the leptomeninges or both.

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Figures

<sc>fig</sc> 1.
fig 1.
Fifteen-year-old girl with transient motor weakness of upper and lower left extremities. A and B, FLAIR images (10000/126/2, TI = 2200) show extensive areas of increased signal intensity in leptomeninges and perivascular spaces, predominantly in right hemisphere. C and D, Contrast-enhanced T1-weighted images (333/14/2, no use of flow compensation) show diffuse leptomeningeal enhancement and strong enhancement of perforating arteries in basal ganglias and deep white matter. Areas of left PCA and some areas of left MCA are spared leptomeningeal enhancement.
See this image and copyright information in PMC

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