{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T07:27:09Z","timestamp":1762327629666,"version":"build-2065373602"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013365","name":"West China Hospital, Sichuan University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013365","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004912","name":"Sichuan University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004912","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The hemodynamic mechanisms underlying revascularization efficacy in moyamoya angiopathy (MMA) and their prognostic implications remain incompletely characterized. This study leverages four-dimensional flow magnetic resonance imaging (4D Flow MRI) to investigate longitudinal hemodynamic changes at the carotid siphons of MMA patients undergoing revascularization, and to evaluate their association with surgical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort of 35 consecutive MMA patients undergoing unilateral revascularization was enrolled at West China Hospital from July 2018 to January 2020. Using 4D Flow MRI, hemodynamic parameters, including mean\/maximum flow, velocity, and wall shear stress, were quantified in the ipsilateral and contralateral carotid siphons at three timepoints: baseline, 1-week postoperative, and 1-year follow-up. Repeated-measures analysis of variance with Bonferroni correction was employed to compare longitudinal changes and correlate findings with 1-year clinical (excellent, good, and poor) and imaging (cerebral perfusion status and Matsushima collateralization grade) outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline and 1-week postoperative assessments revealed that only velocity within contralateral carotid siphon significantly increased (mean velocity: from 20.52 [15.34\u201328.78] cm\/s to 23.70 [16.01\u201339.06] cm\/s,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.026; maximum velocity: from 29.26 [19.68\u201338.39] cm\/s to 33.22 [20.99\u201350.95] cm\/s,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001). However, both carotid siphons demonstrated significant reductions in mean and maximum flow (ipsilateral: mean flow from 1.92 [0.65\u20133.53] mL\/s to 1.31 [0.58\u20132.87] mL\/s,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.043, maximum flow from 2.61 [0.93\u20134.95] mL\/s to 1.97 [0.89\u20133.90] mL\/s,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.036; contralateral: mean flow from 2.87 [0.91\u20134.12] mL\/s to 2.14 [0.81\u20133.78] mL\/s,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.010) at 1-year follow-up. Lower contralateral siphon flow at follow-up correlated with \u201cgood\u201d (but not \u201cexcellent\u201d) clinical outcomes. Reduced flow in both siphons was associated with improved cerebral perfusion and robust collateralization (Matsushima grades A\/B), whereas no changes were observed in patients with poor collaterals (Matsushima grade C).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>4D Flow MRI reveals delayed, bilateral hemodynamic remodeling in MMA at 1-year post-revascularization. These changes correlate with clinical improvement, enhanced perfusion, and collateral development, underscoring the technique utility in monitoring long-term cerebrovascular adaptation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1665883","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:29:04Z","timestamp":1762324144000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic evolution of postoperative hemodynamics in moyamoya angiopathy: a quantitative assessment of 4D Flow MRI and prognostic relevance"],"prefix":"10.3389","volume":"16","author":[{"given":"Chao","family":"Xia","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingzhu","family":"Fu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Tian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutao","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinge","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunchao","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"You","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su","family":"Lui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1001\/archneur.1969.00480090076012","article-title":"Cerebrovascular \"moyamoya\" disease. 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