{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T03:44:03Z","timestamp":1771645443552,"version":"3.50.1"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuropediatrics"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Moyamoya disease (MMD) is characterized by bilateral, chronic progressive stenosis at the terminal portions of the internal carotid arteries and their proximal branches. The \u201csmoke-like\u201d appearance of the arterial collaterals in angiography gives the disease its name. The \u201civy-sign\u201d is the less-known magnetic resonance imaging (MRI) pattern of this disease. The leptomeningeal collaterals present as diffuse signal enhancement at the brain surface in contrast-enhanced T1-weighted image and fluid-attenuated inversion recovery sequences \u201cas if overgrown with ivy.\u201d<\/jats:p><jats:p>We report on three patients with MMD in whom the \u201civy-sign\u201d was already present but misinterpreted in the initial MRI of the brain. The correct diagnosis was made only after repeated MRI.<\/jats:p><jats:p>Using three case studies, we describe the difficulties in the interpretation of the \u201civy-sign\u201d as an MRI pattern. Knowledge of the \u201civy-sign\u201d can be helpful, especially in diseases predisposing to MMD. If this MRI pattern is present, MMD should be considered and MR angiography should be added.<\/jats:p>","DOI":"10.1055\/s-0040-1708546","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T23:23:17Z","timestamp":1585696997000},"page":"241-244","source":"Crossref","is-referenced-by-count":9,"title":["The \u201cIvy-Sign\u201d in Moyamoya Disease\u2014From MRI Pattern to Diagnosis"],"prefix":"10.1055","volume":"51","author":[{"given":"Janina","family":"Gburek-Augustat","sequence":"additional","affiliation":[{"name":"Division of Neuropaediatrics, Hospital for Children and Adolescents, University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ina","family":"Sorge","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology, University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Merkenschlager","sequence":"additional","affiliation":[{"name":"Division of Neuropaediatrics, Hospital for Children and Adolescents, University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,3,31]]},"container-title":["Neuropediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1708546.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T23:17:28Z","timestamp":1595373448000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1708546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,31]]},"references-count":0,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2020,7,21]]},"published-print":{"date-parts":[[2020,8]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1708546","relation":{},"ISSN":["0174-304X","1439-1899"],"issn-type":[{"value":"0174-304X","type":"print"},{"value":"1439-1899","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,31]]}}}