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<meta name="HW.identifier" content="/ajnr/early/2021/03/04/ajnr.A7010.atom" />
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<meta name="DC.Title" content="Ivy Sign in Moyamoya Disease: A Comparative Study of the FLAIR Vascular Hyperintensity Sign Against Contrast-Enhanced MRI" />
<meta name="DC.Identifier" content="10.3174/ajnr.A7010" />
<meta name="DC.Date" content="2021-03-04" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2021 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The ability of the ivy sign on contrast-enhanced T1-weighted MR imaging (CEMR) to reflect cerebral perfusion and postoperative revascularization in Moyamoya disease remains largely unknown. We aimed to compare the capabilities of CEMR and FLAIR.

MATERIALS AND METHODS: CEMR, FLAIR, arterial spin-labeling, and DSA were performed in 44 patients with Moyamoya disease. The ivy sign was scored separately on CEMR and FLAIR using the Alberta Stroke Program Early CT Score. The status of leptomeningeal collaterals was scored on DSA. The postoperative Matsushima grade was evaluated at least 3 months after surgical revascularization.

RESULTS: Scoring of the ivy sign on CEMR showed excellent interrater reliability, and FLAIR vascular hyperintensity showed moderate interrater reliability. Correlation analyses revealed that DSA scores were more consistent with the CEMR-based ivy sign score ( r  =   0.25, P  = .03) than with FLAIR vascular hyperintensity ( r = 0.05, P  = .65). The CEMR-based ivy sign score was significantly correlated with CBF in late-Suzuki stage Moyamoya disease ( t = −2.64, P  = .02). The CEMR-based ivy sign score at baseline was significantly correlated with the postoperative Matsushima grade ( r  =   0.48, P  = .03).

CONCLUSIONS: In this study, CEMR outperformed FLAIR in capturing the ivy sign in Moyamoya disease. In addition, the CEMR-based ivy sign score provided adequate information on hemodynamic status and postoperative neovascularization. The current study suggested that CEMR could be considered as an alternative to FLAIR in future studies investigating leptomeningeal collaterals in Moyamoya disease.

CEMR
:   contrast-enhanced T1-weighted MR imaging
FVH
:   FLAIR vascular hyperintensity
MMD
:   Moyamoya disease
PCA
:   posterior cerebral artery
EDAS
:   encephaloduroarteriosynangiosis
FOV
:   field of view" />
<meta name="DC.Contributor" content="L.-X. Wang" />
<meta name="DC.Contributor" content="H. Wang" />
<meta name="DC.Contributor" content="F.-B. Hao" />
<meta name="DC.Contributor" content="J.-H. Lv" />
<meta name="DC.Contributor" content="S.-H. Zhang" />
<meta name="DC.Contributor" content="D.-S. Han" />
<meta name="DC.Contributor" content="X.-B. Bian" />
<meta name="DC.Contributor" content="D.-K. Zhang" />
<meta name="DC.Contributor" content="Y.-N. Lan" />
<meta name="DC.Contributor" content="X.-R. Wang" />
<meta name="DC.Contributor" content="M.-T. Wei" />
<meta name="DC.Contributor" content="L. Duan" />
<meta name="DC.Contributor" content="L. Ma" />
<meta name="DC.Contributor" content="X. Lou" />
<meta name="article:published_time" content="2021-03-04" />
<meta name="article:section" content="ADULT BRAIN" />
<meta name="citation_title" content="Ivy Sign in Moyamoya Disease: A Comparative Study of the FLAIR Vascular Hyperintensity Sign Against Contrast-Enhanced MRI" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The ability of the ivy sign on contrast-enhanced T1-weighted MR imaging (CEMR) to reflect cerebral perfusion and postoperative revascularization in Moyamoya disease remains largely unknown. We aimed to compare the capabilities of CEMR and FLAIR.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;CEMR, FLAIR, arterial spin-labeling, and DSA were performed in 44 patients with Moyamoya disease. The ivy sign was scored separately on CEMR and FLAIR using the Alberta Stroke Program Early CT Score. The status of leptomeningeal collaterals was scored on DSA. The postoperative Matsushima grade was evaluated at least 3 months after surgical revascularization.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Scoring of the ivy sign on CEMR showed excellent interrater reliability, and FLAIR vascular hyperintensity showed moderate interrater reliability. Correlation analyses revealed that DSA scores were more consistent with the CEMR-based ivy sign score (&lt;i&gt;r &lt;/i&gt;=&lt;i&gt; &lt;/i&gt;0.25, &lt;i&gt;P &lt;/i&gt;= .03) than with FLAIR vascular hyperintensity (&lt;i&gt;r&lt;/i&gt; = 0.05, &lt;i&gt;P &lt;/i&gt;= .65). The CEMR-based ivy sign score was significantly correlated with CBF in late-Suzuki stage Moyamoya disease (&lt;i&gt;t&lt;/i&gt; = −2.64, &lt;i&gt;P &lt;/i&gt;= .02). The CEMR-based ivy sign score at baseline was significantly correlated with the postoperative Matsushima grade (&lt;i&gt;r &lt;/i&gt;=&lt;i&gt; &lt;/i&gt;0.48, &lt;i&gt;P &lt;/i&gt;= .03).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In this study, CEMR outperformed FLAIR in capturing the ivy sign in Moyamoya disease. In addition, the CEMR-based ivy sign score provided adequate information on hemodynamic status and postoperative neovascularization. The current study suggested that CEMR could be considered as an alternative to FLAIR in future studies investigating leptomeningeal collaterals in Moyamoya disease.&lt;/p&gt;" />
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<meta name="twitter:title" content="Ivy Sign in Moyamoya Disease: A Comparative Study of the FLAIR Vascular Hyperintensity Sign Against Contrast-Enhanced MRI" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The ability of the ivy sign on contrast-enhanced T1-weighted MR imaging (CEMR) to reflect cerebral perfusion and postoperative revascularization in Moyamoya disease remains largely unknown. We aimed to compare the capabilities of CEMR and FLAIR.

MATERIALS AND METHODS: CEMR, FLAIR, arterial spin-labeling, and DSA were performed in 44 patients with Moyamoya disease. The ivy sign was scored separately on CEMR and FLAIR using the Alberta Stroke Program Early CT Score. The status of leptomeningeal collaterals was scored on DSA. The postoperative Matsushima grade was evaluated at least 3 months after surgical revascularization.

RESULTS: Scoring of the ivy sign on CEMR showed excellent interrater reliability, and FLAIR vascular hyperintensity showed moderate interrater reliability. Correlation analyses revealed that DSA scores were more consistent with the CEMR-based ivy sign score ( r  =   0.25, P  = .03) than with FLAIR vascular hyperintensity ( r = 0.05, P  = .65). The CEMR-based ivy sign score was significantly correlated with CBF in late-Suzuki stage Moyamoya disease ( t = −2.64, P  = .02). The CEMR-based ivy sign score at baseline was significantly correlated with the postoperative Matsushima grade ( r  =   0.48, P  = .03).

CONCLUSIONS: In this study, CEMR outperformed FLAIR in capturing the ivy sign in Moyamoya disease. In addition, the CEMR-based ivy sign score provided adequate information on hemodynamic status and postoperative neovascularization. The current study suggested that CEMR could be considered as an alternative to FLAIR in future studies investigating leptomeningeal collaterals in Moyamoya disease.

CEMR
:   contrast-enhanced T1-weighted MR imaging
FVH
:   FLAIR vascular hyperintensity
MMD
:   Moyamoya disease
PCA
:   posterior cerebral artery
EDAS
:   encephaloduroarteriosynangiosis
FOV
:   field of view" />
<meta name="og-title" property="og:title" content="Ivy Sign in Moyamoya Disease: A Comparative Study of the FLAIR Vascular Hyperintensity Sign Against Contrast-Enhanced MRI" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2021/03/04/ajnr.A7010" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The ability of the ivy sign on contrast-enhanced T1-weighted MR imaging (CEMR) to reflect cerebral perfusion and postoperative revascularization in Moyamoya disease remains largely unknown. We aimed to compare the capabilities of CEMR and FLAIR.

MATERIALS AND METHODS: CEMR, FLAIR, arterial spin-labeling, and DSA were performed in 44 patients with Moyamoya disease. The ivy sign was scored separately on CEMR and FLAIR using the Alberta Stroke Program Early CT Score. The status of leptomeningeal collaterals was scored on DSA. The postoperative Matsushima grade was evaluated at least 3 months after surgical revascularization.

RESULTS: Scoring of the ivy sign on CEMR showed excellent interrater reliability, and FLAIR vascular hyperintensity showed moderate interrater reliability. Correlation analyses revealed that DSA scores were more consistent with the CEMR-based ivy sign score ( r  =   0.25, P  = .03) than with FLAIR vascular hyperintensity ( r = 0.05, P  = .65). The CEMR-based ivy sign score was significantly correlated with CBF in late-Suzuki stage Moyamoya disease ( t = −2.64, P  = .02). The CEMR-based ivy sign score at baseline was significantly correlated with the postoperative Matsushima grade ( r  =   0.48, P  = .03).

CONCLUSIONS: In this study, CEMR outperformed FLAIR in capturing the ivy sign in Moyamoya disease. In addition, the CEMR-based ivy sign score provided adequate information on hemodynamic status and postoperative neovascularization. The current study suggested that CEMR could be considered as an alternative to FLAIR in future studies investigating leptomeningeal collaterals in Moyamoya disease.

CEMR
:   contrast-enhanced T1-weighted MR imaging
FVH
:   FLAIR vascular hyperintensity
MMD
:   Moyamoya disease
PCA
:   posterior cerebral artery
EDAS
:   encephaloduroarteriosynangiosis
FOV
:   field of view" />
<meta name="og-type" property="og:type" content="article" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">L.-X. Wang</span>, <span class="highwire-citation-author" data-delta="1">H. Wang</span>, <span class="highwire-citation-author" data-delta="2">F.-B. Hao</span>, <span class="highwire-citation-author" data-delta="3">J.-H. Lv</span>, <span class="highwire-citation-author" data-delta="4">S.-H. Zhang</span>, <span class="highwire-citation-author" data-delta="5">D.-S. Han</span>, <span class="highwire-citation-author" data-delta="6">X.-B. Bian</span>, <span class="highwire-citation-author" data-delta="7">D.-K. Zhang</span>, <span class="highwire-citation-author" data-delta="8">Y.-N. Lan</span>, <span class="highwire-citation-author" data-delta="9">X.-R. Wang</span>, <span class="highwire-citation-author" data-delta="10">M.-T. Wei</span>, <span class="highwire-citation-author" data-delta="11">L. Duan</span>, <span class="highwire-citation-author" data-delta="12">L. Ma</span> and <span class="highwire-citation-author" data-delta="13">X. Lou</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">March 2021,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A7010 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-89416--61491099805" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">L.-X. Wang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Medical School of Chinese PLA (L.-X.W., S.-H.Z., D.-S.H.), Beijing, China</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.-X.%2BWang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wang%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.-X.%2BWang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7655-0397" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L.-X. Wang</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">H. Wang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Neurosurgery (H.W., F.-B.H., L.D.), the Fifth Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.%2BWang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wang%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.%2BWang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1152-5860" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. Wang</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">F.-B. Hao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Neurosurgery (H.W., F.-B.H., L.D.), the Fifth Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.-B.%2BHao%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hao%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.-B.%2BHao%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5607-6926" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F.-B. Hao</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">J.-H. Lv </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.-H.%2BLv%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lv%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.-H.%2BLv%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5177-7640" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.-H. Lv</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">S.-H. Zhang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Medical School of Chinese PLA (L.-X.W., S.-H.Z., D.-S.H.), Beijing, China</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.-H.%2BZhang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zhang%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.-H.%2BZhang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7537-876X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.-H. Zhang</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">D.-S. Han </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Medical School of Chinese PLA (L.-X.W., S.-H.Z., D.-S.H.), Beijing, China</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.-S.%2BHan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Han%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.-S.%2BHan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4216-4869" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.-S. Han</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">X.-B. Bian </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=X.-B.%2BBian%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bian%20X&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AX.-B.%2BBian%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7016-6503" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X.-B. Bian</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">D.-K. Zhang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.-K.%2BZhang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zhang%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.-K.%2BZhang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-9711-6733" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.-K. Zhang</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">Y.-N. Lan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.-N.%2BLan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lan%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AY.-N.%2BLan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5569-7883" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Y.-N. Lan</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">X.-R. Wang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=X.-R.%2BWang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wang%20X&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AX.-R.%2BWang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7003-4917" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X.-R. Wang</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">M.-T. Wei </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.-T.%2BWei%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wei%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.-T.%2BWei%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2045-3117" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.-T. Wei</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">L. Duan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Neurosurgery (H.W., F.-B.H., L.D.), the Fifth Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BDuan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Duan%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BDuan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7210-056X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Duan</a></li></ul></div><div class="author-tooltip-12"><div class="author-tooltip-name">L. Ma </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BMa%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ma%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BMa%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2911-3653" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Ma</a></li></ul></div><div class="author-tooltip-13"><div class="author-tooltip-name">X. Lou </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (L.-X.W., J.-H.L., S.-H.Z., D.-S.H., X.-B.B., D.-K.Z., Y.-N.L., X.-R.W., M.-T.W., X.L., L.M.), the First Medical Center, Chinese PLA General Hospital, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=X.%2BLou%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lou%20X&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AX.%2BLou%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2980-5171" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7010v1.1" data-doi="10.1016/S1474-4422(08)70240-0"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Kuroda</span>  <span class="cit-name-given-names">S</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Houkin</span>  <span class="cit-name-given-names">K</span></span></li></ol><cite>. <span class="cit-article-title">Moyamoya disease: current concepts and future perspectives</span>. <abbr class="cit-jnl-abbrev">Lancet Neurol</abbr> <span class="cit-pub-date">2008</span>;<span 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</span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.braindev.2014.06.008</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>25022806</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.braindev.2014.06.008&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=25022806&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2021%2F03%2F04%2Fajnr.A7010.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">23.</span><a class="rev-xref-ref" href="#xref-ref-23-1" title="View reference 23. in text" id="ref-23">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7010v1.23" data-doi="10.1016/j.ejrad.2013.08.040"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Noguchi</span>  <span class="cit-name-given-names">T</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kawashima</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Nishihara</span>  <span class="cit-name-given-names">M</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Arterial spin-labeling MR imaging in Moyamoya disease compared with clinical assessments and other MR imaging findings</span>. <abbr class="cit-jnl-abbrev">Eur J Radiol</abbr> <span class="cit-pub-date">2013</span>;<span class="cit-vol">82</span>:<span class="cit-fpage">e840</span>–<span class="cit-lpage">47</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.ejrad.2013.08.040</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>24055185</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.ejrad.2013.08.040&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=24055185&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2021%2F03%2F04%2Fajnr.A7010.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">24.</span><a class="rev-xref-ref" href="#xref-ref-24-1" title="View reference 24. in text" id="ref-24">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7010v1.24" data-doi="10.3174/ajnr.A2124"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Kawashima</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Noguchi</span>  <span class="cit-name-given-names">T</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Takase</span>  <span class="cit-name-given-names">Y</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Decrease in leptomeningeal ivy sign on fluid-attenuated inversion recovery images after cerebral revascularization in patients with Moyamoya disease</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2010</span>;<span class="cit-vol">31</span>:<span class="cit-fpage">1713</span>–<span class="cit-lpage">18</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3174/ajnr.A2124</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>20466798</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo5OiIzMS85LzE3MTMiO3M6NDoiYXRvbSI7czozODoiL2FqbnIvZWFybHkvMjAyMS8wMy8wNC9ham5yLkE3MDEwLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li></ol></div></div>  </div>

  
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      <div class="highwire-cite-title">Ivy Sign in Moyamoya Disease: A Comparative Study of the FLAIR Vascular Hyperintensity Sign Against Contrast-Enhanced MRI</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">L.-X.</span> <span class="nlm-surname">Wang</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Wang</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">F.-B.</span> <span class="nlm-surname">Hao</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">J.-H.</span> <span class="nlm-surname">Lv</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">S.-H.</span> <span class="nlm-surname">Zhang</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.-S.</span> <span class="nlm-surname">Han</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">X.-B.</span> <span class="nlm-surname">Bian</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">D.-K.</span> <span class="nlm-surname">Zhang</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Y.-N.</span> <span class="nlm-surname">Lan</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">X.-R.</span> <span class="nlm-surname">Wang</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">M.-T.</span> <span class="nlm-surname">Wei</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Duan</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Ma</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">X.</span> <span class="nlm-surname">Lou</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2021, </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A7010 </span></div>
  
  
  
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