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American Journal of Neuroradiology 20:1836-1838 (11 1999)
© 1999 American Society of Neuroradiology

ARTICLE

"Ivy Sign" on Fluid-Attenuated Inversion-Recovery Images in Childhood Moyamoya Disease

Masayuki Maeda^,a and Chika Tsuchida^a

^a From the Department of Radiology (M.M.), Maizuru Kyosai Hospital, Kyoto, Japan and the Department of Radiology (C.T.), Hayashi Hospital, Fukui, Japan.

Summary: 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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