The âivy sign scoreâ on FLAIR MR images: Clinical utility following revascularization in pediatric Moyamoya disease
Purpose: The aim was to evaluate post-operative changes in the Ivy sign on unenhanced fluid-attenuated inversion-recovery (FLAIR) following surgical intervention in pediatric Moyamoya disease (MMD) and assess its clinical utility as an indicator of hemodynamic improvement. Patients and methods: Fift...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-09-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0378603X17300621 |
| _version_ | 1819010389121171456 |
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| author | Mona El-Kalioubie Wessam Abdelrahman Elzayat Hassan Ali El-kiki Mohamed Alaa Eldin Thabit |
| author_facet | Mona El-Kalioubie Wessam Abdelrahman Elzayat Hassan Ali El-kiki Mohamed Alaa Eldin Thabit |
| author_sort | Mona El-Kalioubie |
| collection | DOAJ |
| description | Purpose: The aim was to evaluate post-operative changes in the Ivy sign on unenhanced fluid-attenuated inversion-recovery (FLAIR) following surgical intervention in pediatric Moyamoya disease (MMD) and assess its clinical utility as an indicator of hemodynamic improvement. Patients and methods: Fifteen pediatric patients with MMD were included in this retrospective study. Surgical revascularization had been done in all patients on the cerebral hemisphere with reduced cerebral vascular reserve (CVR); one of them had bilateral surgery (n = 16). FLAIR examinations were reviewed in each patient, pre and post-operative. We compared the pre and post-operative total Ivy score (TIS) for each of the 16 hemispheres and correlated them with the clinical status. Results: FLAIR images depicted the Ivy sign pre-operatively in all 16 hemispheres and a strong positive correlation between the TIS and the grade of clinical hemispheric symptom (p < 0.00001). Following surgery, reduction of the TIS was seen in 13 (81.25%) out of the 16 hemispheres while the TIS remained unchanged in 3 (18.75%) hemispheres. All patients with reduced Ivy signs post-operatively showed improvement of pre-operative clinical symptoms with moderate positive correlation (p = 0.01). Conclusion: A change in the postoperative Ivy sign can be an indicator of effective cerebral reperfusion in MMD. Keywords: Ivy sign score, FLAIR, Moyamoya, Post-operative, Pediatric, Revascularization |
| first_indexed | 2024-12-21T01:11:29Z |
| format | Article |
| id | doaj.art-cf624f8697b241b695fef7bec2326992 |
| institution | Directory Open Access Journal |
| issn | 0378-603X |
| language | English |
| last_indexed | 2024-12-21T01:11:29Z |
| publishDate | 2017-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-cf624f8697b241b695fef7bec23269922022-12-21T19:20:55ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine0378-603X2017-09-01483695700The âivy sign scoreâ on FLAIR MR images: Clinical utility following revascularization in pediatric Moyamoya diseaseMona El-Kalioubie0Wessam Abdelrahman Elzayat1Hassan Ali El-kiki2Mohamed Alaa Eldin Thabit3Diagnostic and Intervention Radiology Department, Cairo University Hospitals, Kasr Al-Ainy, Cairo, Egypt; Corresponding author at: Diagnostic and Intervention Radiology Department, Cairo University Hospitals, Kasr Al-Ainy, El-Manial, 11956 Cairo, Egypt.Diagnostic and Intervention Radiology Department, Cairo University Hospitals, Kasr Al-Ainy, Cairo, EgyptDiagnostic and Intervention Radiology Department, Cairo University Hospitals, Kasr Al-Ainy, Cairo, EgyptNeurosurgery Department, Cairo University Hospitals, Kasr Al-Ainy, Cairo, EgyptPurpose: The aim was to evaluate post-operative changes in the Ivy sign on unenhanced fluid-attenuated inversion-recovery (FLAIR) following surgical intervention in pediatric Moyamoya disease (MMD) and assess its clinical utility as an indicator of hemodynamic improvement. Patients and methods: Fifteen pediatric patients with MMD were included in this retrospective study. Surgical revascularization had been done in all patients on the cerebral hemisphere with reduced cerebral vascular reserve (CVR); one of them had bilateral surgery (n = 16). FLAIR examinations were reviewed in each patient, pre and post-operative. We compared the pre and post-operative total Ivy score (TIS) for each of the 16 hemispheres and correlated them with the clinical status. Results: FLAIR images depicted the Ivy sign pre-operatively in all 16 hemispheres and a strong positive correlation between the TIS and the grade of clinical hemispheric symptom (p < 0.00001). Following surgery, reduction of the TIS was seen in 13 (81.25%) out of the 16 hemispheres while the TIS remained unchanged in 3 (18.75%) hemispheres. All patients with reduced Ivy signs post-operatively showed improvement of pre-operative clinical symptoms with moderate positive correlation (p = 0.01). Conclusion: A change in the postoperative Ivy sign can be an indicator of effective cerebral reperfusion in MMD. Keywords: Ivy sign score, FLAIR, Moyamoya, Post-operative, Pediatric, Revascularizationhttp://www.sciencedirect.com/science/article/pii/S0378603X17300621 |
| spellingShingle | Mona El-Kalioubie Wessam Abdelrahman Elzayat Hassan Ali El-kiki Mohamed Alaa Eldin Thabit The âivy sign scoreâ on FLAIR MR images: Clinical utility following revascularization in pediatric Moyamoya disease The Egyptian Journal of Radiology and Nuclear Medicine |
| title | The âivy sign scoreâ on FLAIR MR images: Clinical utility following revascularization in pediatric Moyamoya disease |
| title_full | The âivy sign scoreâ on FLAIR MR images: Clinical utility following revascularization in pediatric Moyamoya disease |
| title_fullStr | The âivy sign scoreâ on FLAIR MR images: Clinical utility following revascularization in pediatric Moyamoya disease |
| title_full_unstemmed | The âivy sign scoreâ on FLAIR MR images: Clinical utility following revascularization in pediatric Moyamoya disease |
| title_short | The âivy sign scoreâ on FLAIR MR images: Clinical utility following revascularization in pediatric Moyamoya disease |
| title_sort | aivy sign scorea on flair mr images clinical utility following revascularization in pediatric moyamoya disease |
| url | http://www.sciencedirect.com/science/article/pii/S0378603X17300621 |
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