Authors: Sandra Vuignier Masaki Ito Kota Kurisu Ken Kazumata Naoki Nakayama Hideo Shichinohe Tohru Shiga Jozsef Zoltan Kiss Nagara Tamaki Kiyohiro Houkin
Publish Date: 2013/09/14
Volume: 155, Issue: 11, Pages: 2097-2104
Abstract
The prevalence of ivy sign on fluidattenuated inversion recovery FLAIR imaging in patients with asymptomatic moyamoya disease is unclear The aim of this study was to clarify the incidence of ivy sign in these patients as well as the correlation between MRI and 15O gas PET findingsA retrospective analysis including 16 consecutive patients with asymptomatic moyamoya disease enrolled between 2001 and 2010 in a single center FLAIR imaging at the initial visit was categorized as ivy sign present negative or equivocal Hemodynamic and metabolic parameters were quantified in 11 of 16 patients by 15Ogas positron emission tomography and the relationship between ivy sign and 15Ogas PET parameters was analyzed Cerebrovascular events within the followup period 54 ± 28 months were also examinedFive of 16 asymptomatic moyamoya patients 313 had positive ivy sign 6/30 hemispheres 20 In 15Ogas PET examinations 18 of 22 hemispheres had elevated oxygen extraction fraction values that were significantly associated with positive ivy sign Of these 16 asymptomatic moyamoya patients six patients 375 underwent combined surgical revascularization In this series no patients experienced ischemic stroke but one had intraventricular bleeding 1 year after surgeryIvy sign on FLAIR imaging is still not rare in patients with moyamoya disease even when asymptomatic Although optimal management is still under debate ivy sign may be an indicator of misery perfusion and patients with asymptomatic moyamoya disease and ivy sign on FLAIR imaging will benefit from more careful followup
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