title: "Ivy sign" on fluid-attenuated inversion-recovery images in childhood moyamoya disease.
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.
authors.affiliation: Deaprtment of Radiology, Maizuru Kyosai Hospital, Maizuru City, Kyoto, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Maeda
authors.forename: C
authors.initials: C
authors.lastname: Tsuchida
mesh_terms: D000293:Adolescent; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008576:Meningeal Arteries / Q000473:pathology; D008578:Meninges / Q000098:blood supply* / Q000473:pathology; D009072:Moyamoya Disease / Q000175:diagnosis*; D012680:Sensitivity and Specificity