New Imaging Biomarker Shows Promise in Predicting Stroke Risk for Moyamoya Disease Patients
Table of Contents
A novel imaging technique utilizing a scoring system for “Ivy Sign” visibility on MRI scans may significantly improve stroke risk assessment and prognosis for individuals with moyamoya disease, a rare and debilitating cerebrovascular disorder.
Moyamoya disease is characterized by the progressive narrowing or blockage of major blood vessels supplying the brain, leading to insufficient blood flow and an elevated risk of stroke. Researchers at Kyung Hee University Hospital in South Korea have identified a potential new tool to better understand and predict the course of this challenging condition.
Identifying Abnormal Signals in Blood Vessel Walls
A team led by Professor Yoo Ji-wook in the Department of Neurosurgery recently published findings detailing the identification of abnormal signals within the blood vessel walls of adult patients diagnosed with moyamoya disease. The study, published in the latest issue of Stroke: Vascular and Interventional Neurology (IF 2.8), an SIC-level international journal, focused on analyzing the impact of these signals on both stroke diagnosis and patient outcomes.
The research involved a comprehensive analysis of high-resolution blood vessel wall MRI data collected from 125 patients. Researchers consistently observed what is known as the Ivy Sign (VIS) – a vine-like pattern surrounding blood vessels – indicating functional changes in the vessels through a process called ‘contrast enhancement.’
Quantifying the Ivy Sign with the TVIS System
To better understand the extent and severity of these vascular changes, the team developed the Total Vessel Wall Magnetic Resonance Ivy Sign (TVIS) score. This system quantifies the scope and degree of the Ivy Sign across six specific regions of the brain: the superior frontal, inferior frontal, precentral, central, postcentral, and parietal sulci.
Evaluation revealed the Ivy Sign was most prominent in the central sulcus, diminishing in visibility as distance from this central area increased. Crucially, further analysis demonstrated a direct correlation between higher TVIS scores and an increased risk of both ischemic and hemorrhagic stroke.
“The Ivy Sign is an abnormal signal intensity that appears in the blood vessel wall and is evaluated as an important imaging feature that can reflect the activation or pathological progression of moyamoya disease,” explained Professor Yoo Ji-wook. “Through this study, we confirmed that the TVIS system that evaluates the Ivy Sign has potential value as a predictive imaging biomarker that can determine the type of stroke and blood flow status.”
Implications for Future Diagnosis and Treatment
This research suggests the TVIS system could become a valuable tool for clinicians managing patients with moyamoya disease. By providing a more precise assessment of disease activity and stroke risk, the TVIS score may help guide treatment decisions and improve patient outcomes. Further research is needed to validate these findings in larger, more diverse patient populations, but the initial results offer a promising step forward in the fight against this rare and devastating disease.
The full study, titled ‘Sulcus high-signal vascular sign observed by vascular wall MRI in adult moyamoya disease,’ is available in the latest issue of Stroke: Vascular and Interventional Neurology.
