{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T18:20:18Z","timestamp":1759602018933,"version":"3.40.5"},"reference-count":23,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Objective:&lt;\/i&gt;&lt;\/b&gt; Infarction is one of the most common postoperative complications after surgical revascularization for moyamoya disease (MMD). Increased conspicuity of deep medullary veins (DMVs) on susceptibility-weighted imaging (SWI), known as \u201cbrush sign,\u201d could predict the severity of MMD. This study aimed to reveal the features of the \u201cbrush sign\u201d in preoperative SWI and to verify its relationship to postoperative infarction. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; Consecutive patients with MMD who had undergone cerebral revascularization surgery were included. Routine preoperative SWI was performed. The \u201cbrush sign\u201d was defined according to the number of the conspicuous DMVs &amp;#x3e; 5 detected on SWI. Postoperative infarctions were defined as the high-intensity signal on postoperative DWI images, with or without neurologic deficits. The modified Rankin scale (mRS) was applied to evaluate the prognosis of patients. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; In the enrolled 100 hemispheres, 35 were presented with the \u201cbrush sign.\u201d Patients with ischemic onset manifestation and previous infarction history tended to present with the \u201cbrush sign.\u201d Multivariate analysis showed that the \u201cbrush sign\u201d (OR 13.669; 95% CI, 1.747\u2013106.967, &lt;i&gt;p&lt;\/i&gt; = 0.013) and decreased rCBF (OR 6.050; 95% CI, 1.052\u201334.799, &lt;i&gt;p&lt;\/i&gt; = 0.044) were independent risk factors of postoperative infarction. Besides, the \u201cbrush sign\u201d showed a significant correlation with a higher mRS score at discharge (&lt;i&gt;p&lt;\/i&gt; = 0.047). &lt;b&gt;&lt;i&gt;Conclusion:&lt;\/i&gt;&lt;\/b&gt; The findings strongly suggest that the presence of the \u201cbrush sign\u201d preoperatively can be a predictor of infarction after surgical revascularization for ischemic MMD. It may contribute to an improved surgical result through focused perioperative management based on appropriate surgical risk stratification. <\/jats:p>","DOI":"10.1159\/000511936","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T22:05:07Z","timestamp":1612821907000},"page":"147-155","source":"Crossref","is-referenced-by-count":7,"title":["Clinical Implications of the \u201cBrush Sign\u201d in Susceptibility-Weighted Imaging for Moyamoya Disease"],"prefix":"10.1159","volume":"50","author":[{"given":"Junlin","family":"Lu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yahui","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingtao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xun","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaolin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3263-6797","authenticated-orcid":false,"given":"Yuanli","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2021,2,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70240-0"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3171\/2009.4.JNS081649"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0804622"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.006009"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3171\/2014.1.JNS13946"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3171\/2014.10.JNS14231"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.20404"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00055"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A0786"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2568"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3171\/2017.10.JNS171749"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199209000-00003"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198411000-00002"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.14.1.104"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000013672.70986.e2"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000311067.41239.E6"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2016.03.053"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3171\/2016.3.JNS152256"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2000.93.3.0397"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2000.93.6.0976"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1007\/BF02985101"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2003.025049"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2014.08.012"}],"container-title":["Cerebrovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/511936","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/511936","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:11:53Z","timestamp":1745424713000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000511936"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,4,8]]},"published-print":{"date-parts":[[2021,4,13]]}},"URL":"https:\/\/doi.org\/10.1159\/000511936","archive":["Portico"],"relation":{},"ISSN":["1015-9770","1421-9786"],"issn-type":[{"type":"print","value":"1015-9770"},{"type":"electronic","value":"1421-9786"}],"subject":[],"published":{"date-parts":[[2021]]}}}