• Feng Gao, Wei Zhao, Yu Zheng, Shihong Li, Guangwu Lin, Ming Ji, Yu Duan, Jian Li, and Yanqing Hua.
• Department of Radiology, Huadong Hospital Fudan University, Shanghai, China.
• World Neurosurg. 2019 Sep 1; 129: e48-e55.

ObjectiveTo investigate potential risk factors for cerebral hyperperfusion syndrome (CHS) after surgery in patients with moyamoya disease (MMD) using phase-contrast magnetic resonance imaging (MRI).MethodsThe study included 84 adult patients (89 brain hemispheres) with MMD who underwent surgery. Preoperative phase-contrast MRI scans were performed for all patients. Peak velocity, average velocity, average flow, forward volume, and region of interest area of the bilateral internal and external carotid arteries, superficial temporal artery, and vertebral artery were calculated and analyzed. Patients were divided into CHS and non-CHS groups. Patients' age, sex, clinical symptoms, Suzuki stage, and MRI flow examination results were compared between the 2 groups.ResultsNineteen of 84 patients (89 hemispheres) with MMD were in the CHS group. Patients with ischemic onset symptoms were more likely to develop CHS after surgery (P < 0.05). There were no significant differences in age, sex, and Suzuki stage between the 2 groups. For surgery ipsilateral vessels, peak velocity, average flow and forward volume of superficial temporal artery and average flow of external carotid artery and region of interest area of internal carotid artery in the CHS group were significantly lower compared with the non-CHS group (P < 0.05). For surgery contralateral vessels, forward volume of superficial temporal artery and external carotid artery in the CHS group was significantly lower compared with the non-CHS group (P < 0.05).ConclusionsPatients with MMD and ischemic onset symptoms are more likely to develop CHS after surgery. Preoperative phase-contrast MRI analysis may be helpful to predict CHS in patients with MMD after surgery.Copyright © 2019 Elsevier Inc. All rights reserved.

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