{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T23:44:33Z","timestamp":1780616673326,"version":"3.54.1"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2015,9,14]],"date-time":"2015-09-14T00:00:00Z","timestamp":1442188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2015,9,14]],"date-time":"2015-09-14T00:00:00Z","timestamp":1442188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Moyamoya disease leads to the formation of stenosis in the cerebrovasculature. A superficial temporal artery to middle cerebral artery (STA-MCA) bypass is an effective treatment for the disease, yet it is usually associated with postoperative cerebral hyperperfusion syndrome (CHS). This study aimed to evaluate cerebral hemodynamic changes immediately after surgery and assess whether a semiquantitative analysis of an intraoperative magnetic resonance perfusion-weighted image (PWI) is useful for predicting postoperative CHS. Fourteen patients who underwent the STA-MCA bypass surgery were included in this study. An atlas-based registration method was employed for studying hemodynamics in different cerebral regions. Pre- versus intraoperative and group-wise comparisons were conducted to evaluate the hemodynamic changes. A postoperative increase in relative cerebral blood flow (CBF) at the terminal MCA territory (<jats:italic>P\u2009<\/jats:italic>=\u20090.035) and drop in relative mean-time-transit at the central MCA territory (<jats:italic>P\u2009<\/jats:italic>=\u20090.012) were observed in all patients. However, a significant raise in the increasing ratio of relative-CBF at the terminal MCA territory was only found in CHS patients (<jats:italic>P\u2009<\/jats:italic>=\u20090.023). The cerebrovascular changes of the patients after revascularization treatment were confirmed. Intraoperative PWI might be helpful in predicting the change in relative-CBF at MCA terminal territory which might indicate a risk of CHS.<\/jats:p>","DOI":"10.1038\/srep14140","type":"journal-article","created":{"date-parts":[[2015,9,14]],"date-time":"2015-09-14T09:59:31Z","timestamp":1442224771000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Predicting Cerebral Hyperperfusion Syndrome Following Superficial Temporal Artery to Middle Cerebral Artery Bypass based on Intraoperative Perfusion-Weighted Magnetic Resonance Imaging"],"prefix":"10.1038","volume":"5","author":[{"given":"Defeng","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengping","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka Ming","family":"Fung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yishan","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winnie Chiu Wing","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent Chung","family":"Tong Mok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinsong","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil T.","family":"Ahuja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2015,9,14]]},"reference":[{"key":"BFsrep14140_CR1","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/S1474-4422(08)70240-0","volume":"7","author":"S Kuroda","year":"2008","unstructured":"Kuroda, S. & Houkin, K. Moyamoya disease: current concepts and future perspectives. Lancet neurology 7, 1056\u20131066, 10.1016\/S1474-4422(08)70240-0 (2008).","journal-title":"Lancet neurology"},{"key":"BFsrep14140_CR2","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1159\/000336765","volume":"33","author":"M Fujimura","year":"2012","unstructured":"Fujimura, M. et al. Efficacy of prophylactic blood pressure lowering according to a standardized postoperative management protocol to prevent symptomatic cerebral hyperperfusion after direct revascularization surgery for moyamoya disease. Cerebrovasc Dis 33, 436\u2013445, 10.1159\/000336765 (2012).","journal-title":"Cerebrovasc Dis"},{"key":"BFsrep14140_CR3","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1007\/s00701-012-1575-y","volume":"155","author":"H Uchino","year":"2013","unstructured":"Uchino, H. et al. Semiquantitative analysis of indocyanine green videoangiography for cortical perfusion assessment in superficial temporal artery to middle cerebral artery anastomosis. Acta Neurochir (Wien) 155, 599\u2013605, 10.1007\/s00701-012-1575-y (2013).","journal-title":"Acta Neurochir (Wien)"},{"key":"BFsrep14140_CR4","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.surneu.2006.07.017","volume":"67","author":"M Fujimura","year":"2007","unstructured":"Fujimura, M., Kaneta, T., Mugikura, S., Shimizu, H. & Tominaga, T. Temporary neurologic deterioration due to cerebral hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in patients with adult-onset moyamoya disease. Surg Neurol 67, 273\u2013282, 10.1016\/j.surneu.2006.07.017 (2007).","journal-title":"Surg Neurol"},{"key":"BFsrep14140_CR5","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1016\/S1474-4422(05)70251-9","volume":"4","author":"WN van Mook","year":"2005","unstructured":"van Mook, W. N. et al. Cerebral hyperperfusion syndrome. Lancet neurology 4, 877\u2013888, 10.1016\/S1474-4422(05)70251-9 (2005).","journal-title":"Lancet neurology"},{"key":"BFsrep14140_CR6","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s00415-009-5384-z","volume":"257","author":"S Ivens","year":"2010","unstructured":"Ivens, S., Gabriel, S., Greenberg, G., Friedman, A. & Shelef, I. Blood-brain barrier breakdown as a novel mechanism underlying cerebral hyperperfusion syndrome. Journal of neurology 257, 615\u2013620, 10.1007\/s00415-009-5384-z (2010).","journal-title":"Journal of neurology"},{"key":"BFsrep14140_CR7","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1097\/00004647-199804000-00011","volume":"18","author":"L Ostergaard","year":"1998","unstructured":"Ostergaard, L. et al. Absolute cerebral blood flow and blood volume measured by magnetic resonance imaging bolus tracking: comparison with positron emission tomography values. Journal of cerebral blood flow and metabolism 18, 425\u2013432, 10.1097\/00004647-199804000-00011 (1998).","journal-title":"Journal of cerebral blood flow and metabolism"},{"key":"BFsrep14140_CR8","first-page":"533","volume":"56","author":"TM Sundt Jr.","year":"1981","unstructured":"Sundt, T. M. Jr., et al. Correlation of cerebral blood flow and electroencephalographic changes during carotid endarterectomy: with results of surgery and hemodynamics of cerebral ischemia. Mayo Clinic proceedings 56, 533\u2013543 (1981).","journal-title":"Mayo Clinic proceedings"},{"key":"BFsrep14140_CR9","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.1016\/j.jvs.2008.11.026","volume":"49","author":"KG Moulakakis","year":"2009","unstructured":"Moulakakis, K. G., Mylonas, S. N., Sfyroeras, G. S. & Andrikopoulos, V. Hyperperfusion syndrome after carotid revascularization. Journal of vascular surgery 49, 1060\u20131068, 10.1016\/j.jvs.2008.11.026 (2009).","journal-title":"Journal of vascular surgery"},{"key":"BFsrep14140_CR10","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1136\/jnnp-2012-303659","volume":"84","author":"MB Maas","year":"2013","unstructured":"Maas, M. B., Kwolek, C. J., Hirsch, J. A., Jaff, M. R. & Rordorf, G. A. Clinical risk predictors for cerebral hyperperfusion syndrome after carotid endarterectomy. Journal of neurology, neurosurgery and psychiatry 84, 569\u2013572, 10.1136\/jnnp-2012-303659 (2013).","journal-title":"Journal of neurology, neurosurgery and psychiatry"},{"key":"BFsrep14140_CR11","doi-asserted-by":"publisher","first-page":"S238","DOI":"10.1016\/S0303-8467(97)00082-6","volume":"99 Suppl 2","author":"M Fukui","year":"1997","unstructured":"Fukui, M. Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (\u2018moyamoya\u2019 disease). Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Clinical neurology and neurosurgery 99 Suppl 2, S238\u2013240 (1997).","journal-title":"Clinical neurology and neurosurgery"},{"key":"BFsrep14140_CR12","first-page":"4398","volume":"125","author":"B Xu","year":"2012","unstructured":"Xu, B. et al. Superficial temporal artery-middle cerebral artery bypass combined with encephalo-duro-myo-synangiosis in treating moyamoya disease: surgical techniques, indications and midterm follow-up results. Chinese medical journal 125, 4398\u20134405 (2012).","journal-title":"Chinese medical journal"},{"key":"BFsrep14140_CR13","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1002\/mrm.1910360510","volume":"36","author":"L Ostergaard","year":"1996","unstructured":"Ostergaard, L., Weisskoff, R. M., Chesler, D. A., Gyldensted, C. & Rosen, B. R. High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: Mathematical approach and statistical analysis. Magnetic resonance in medicine 36, 715\u2013725 (1996).","journal-title":"Magnetic resonance in medicine"},{"key":"BFsrep14140_CR14","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1148\/radiol.254082000","volume":"254","author":"K Kudo","year":"2010","unstructured":"Kudo, K. et al. Differences in CT perfusion maps generated by different commercial software: quantitative analysis by using identical source data of acute stroke patients. Radiology 254, 200\u2013209, 10.1148\/radiol.254082000 (2010).","journal-title":"Radiology"},{"key":"BFsrep14140_CR15","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1038\/jcbfm.2010.106","volume":"31","author":"M Sasaki","year":"2011","unstructured":"Sasaki, M. et al. Prediction of infarct volume and neurologic outcome by using automated multiparametric perfusion-weighted magnetic resonance imaging in a primate model of permanent middle cerebral artery occlusion. Journal of cerebral blood flow and metabolism 31, 448\u2013456, 10.1038\/jcbfm.2010.106 (2011).","journal-title":"Journal of cerebral blood flow and metabolism"},{"key":"BFsrep14140_CR16","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1016\/j.jstrokecerebrovasdis.2012.10.002","volume":"22","author":"M Sasaki","year":"2013","unstructured":"Sasaki, M. et al. Penumbral imaging by using perfusion computed tomography and perfusion-weighted magnetic resonance imaging: current concepts. Journal of stroke and cerebrovascular diseases 22, 1212\u20131215, 10.1016\/j.jstrokecerebrovasdis.2012.10.002 (2013).","journal-title":"Journal of stroke and cerebrovascular diseases"},{"key":"BFsrep14140_CR17","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1038\/jcbfm.2008.155","volume":"29","author":"EJ Bleeker","year":"2009","unstructured":"Bleeker, E. J., van Buchem, M. A. & van Osch, M. J. Optimal location for arterial input function measurements near the middle cerebral artery in first-pass perfusion MRI. Journal of cerebral blood flow and metabolism 29, 840\u2013852, 10.1038\/jcbfm.2008.155 (2009).","journal-title":"Journal of cerebral blood flow and metabolism"},{"key":"BFsrep14140_CR18","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1002\/mrm.10522","volume":"50","author":"O Wu","year":"2003","unstructured":"Wu, O. et al. Tracer arrival timing-insensitive technique for estimating flow in MR perfusion-weighted imaging using singular value decomposition with a block-circulant deconvolution matrix. Magnetic resonance in medicine 50, 164\u2013174, 10.1002\/mrm.10522 (2003).","journal-title":"Magnetic resonance in medicine"},{"key":"BFsrep14140_CR19","unstructured":"Oppenheim, A. V. & Schafer, R. W. Discrete-time signal processing. (Prentice Hall, 1989)."},{"key":"BFsrep14140_CR20","first-page":"639","volume":"17","author":"LM Hamberg","year":"1996","unstructured":"Hamberg, L. M. et al. Quantitative high-resolution measurement of cerebrovascular physiology with slip-ring CT. American journal of neuroradiology 17, 639\u2013650 (1996).","journal-title":"American journal of neuroradiology"},{"key":"BFsrep14140_CR21","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1159\/000333602","volume":"30","author":"L Tatu","year":"2012","unstructured":"Tatu, L., Moulin, T., Vuillier, F. & Bogousslavsky, J. Arterial territories of the human brain. Frontiers of neurology and neuroscience 30, 99\u2013110, 10.1159\/000333602 (2012).","journal-title":"Frontiers of neurology and neuroscience"},{"key":"BFsrep14140_CR22","doi-asserted-by":"publisher","first-page":"e57595","DOI":"10.1371\/journal.pone.0057595","volume":"8","author":"J Zhang","year":"2013","unstructured":"Zhang, J. et al. Whole-brain CT perfusion and CT angiography assessment of Moyamoya disease before and after surgical revascularization: preliminary study with 256-slice CT. PloS one 8, e57595, 10.1371\/journal.pone.0057595 (2013).","journal-title":"PloS one"},{"key":"BFsrep14140_CR23","doi-asserted-by":"publisher","first-page":"ons151","DOI":"10.1227\/NEU.0b013e318277c606","volume":"72","author":"C Roder","year":"2013","unstructured":"Roder, C. et al. Intraoperative visualization of residual tumor: the role of perfusion-weighted imaging in a high-field intraoperative magnetic resonance scanner. Neurosurgery 72, ons151\u2013158, discussion ons158, 10.1227\/NEU.0b013e318277c606 (2013).","journal-title":"Neurosurgery"},{"key":"BFsrep14140_CR24","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1016\/S0090-3019(01)00594-8","volume":"56","author":"V Rohde","year":"2001","unstructured":"Rohde, V. et al. The role of intraoperative magnetic resonance imaging for the detection of hemorrhagic complications during surgery for intracerebral lesions an experimental approach. Surg Neurol 56, 266\u2013274, discussion 274-265 (2001).","journal-title":"Surg Neurol"},{"key":"BFsrep14140_CR25","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1159\/000350197","volume":"35","author":"Z Li","year":"2013","unstructured":"Li, Z. et al. Perfusion-weighted magnetic resonance imaging used in assessing hemodynamics following superficial temporal artery-middle cerebral artery bypass in patients with Moyamoya disease. Cerebrovasc Dis 35, 455\u2013460, 10.1159\/000350197 (2013).","journal-title":"Cerebrovasc Dis"},{"key":"BFsrep14140_CR26","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1148\/radiol.2221010471","volume":"222","author":"JD Eastwood","year":"2002","unstructured":"Eastwood, J. D. et al. CT perfusion scanning with deconvolution analysis: pilot study in patients with acute middle cerebral artery stroke. Radiology 222, 227\u2013236 (2002).","journal-title":"Radiology"},{"key":"BFsrep14140_CR27","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1161\/01.STR.0000166181.86928.8b","volume":"36","author":"KS Butcher","year":"2005","unstructured":"Butcher, K. S. et al. Refining the perfusion-diffusion mismatch hypothesis. Stroke 36, 1153\u20131159 (2005).","journal-title":"Stroke"},{"key":"BFsrep14140_CR28","doi-asserted-by":"publisher","first-page":"843","DOI":"10.3171\/jns.1994.81.6.0843","volume":"81","author":"K Ikezaki","year":"1994","unstructured":"Ikezaki, K. et al. Cerebral circulation and oxygen metabolism in childhood moyamoya disease: a perioperative positron emission tomography study. Journal of neurosurgery 81, 843\u2013850, 10.3171\/jns.1994.81.6.0843 (1994).","journal-title":"Journal of neurosurgery"},{"key":"BFsrep14140_CR29","first-page":"736","volume":"46","author":"E Fricke","year":"2005","unstructured":"Fricke, E. et al. Attenuation correction of myocardial SPECT perfusion images with low-dose CT: evaluation of the method by comparison with perfusion PET. Journal of nuclear medicine 46, 736\u2013744 (2005).","journal-title":"Journal of nuclear medicine"},{"key":"BFsrep14140_CR30","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s00701-005-0634-z","volume":"148","author":"S Sakamoto","year":"2006","unstructured":"Sakamoto, S. et al. CT perfusion imaging for childhood moyamoya disease before and after surgical revascularization. Acta Neurochir (Wien) 148, 77\u201381, discussion 81, 10.1007\/s00701-005-0634-z (2006).","journal-title":"Acta Neurochir (Wien)"},{"key":"BFsrep14140_CR31","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1007\/s00381-011-1658-8","volume":"28","author":"J Bai","year":"2012","unstructured":"Bai, J. et al. Regional cerebral perfusion and ischemic status after standard superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery in ischemic cerebrovascular disease. Child\u2019s nervous system 28, 579\u2013586, 10.1007\/s00381-011-1658-8 (2012).","journal-title":"Child\u2019s nervous system"},{"key":"BFsrep14140_CR32","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.surneu.2009.06.023","volume":"73","author":"AK Nair","year":"2010","unstructured":"Nair, A. K., Drazin, D., Yamamoto, J. & Boulos, A. S. Computed tomographic perfusion in assessing postoperative revascularization in moyamoya disease. World neurosurgery 73, 93\u201399, discussion e13, 10.1016\/j.surneu.2009.06.023 (2010).","journal-title":"World neurosurgery"},{"key":"BFsrep14140_CR33","doi-asserted-by":"publisher","first-page":"2066","DOI":"10.1038\/jcbfm.2012.110","volume":"32","author":"Y Kaku","year":"2012","unstructured":"Kaku, Y. et al. Cerebral blood flow and metabolism of hyperperfusion after cerebral revascularization in patients with moyamoya disease. Journal of cerebral blood flow and metabolism 32, 2066\u20132075, 10.1038\/jcbfm.2012.110 (2012).","journal-title":"Journal of cerebral blood flow and metabolism"},{"key":"BFsrep14140_CR34","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1159\/000068050","volume":"38","author":"SK Kim","year":"2003","unstructured":"Kim, S. K. et al. Evaluation of cerebral hemodynamics with perfusion MRI in childhood moyamoya disease. Pediatric neurosurgery 38, 68\u201375, 10.1159\/000068050 (2003).","journal-title":"Pediatric neurosurgery"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/srep14140","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep14140.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep14140.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:15:26Z","timestamp":1672964126000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/srep14140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,14]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2015,11,26]]}},"alternative-id":["BFsrep14140"],"URL":"https:\/\/doi.org\/10.1038\/srep14140","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9,14]]},"assertion":[{"value":"27 January 2015","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2015","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 September 2015","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"14140"}}