title: Time-of-Flight MR Angiography for Detection of Cerebral Hyperperfusion Syndrome after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis in Moyamoya Disease.
abstract: Cerebral hyperperfusion syndrome is a potential complication of superficial temporal artery-MCA anastomosis for Moyamoya disease. In this study, we evaluated whether TOF-MRA could assess cerebral hyperperfusion syndrome after superficial temporal artery-MCA anastomosis for this disease.
  
  
  
  This retrospective study included patients with Moyamoya disease who underwent superficial temporal artery-MCA single anastomosis. TOF-MRA and SPECT were performed before and 1-6 days after anastomosis. Bilateral ROIs on the source image of TOF-MRA were manually placed directly on the parietal branch of the superficial temporal artery just after branching the frontal branch of the superficial temporal artery and on the contralateral superficial temporal artery on the same axial image, respectively. The change ratio of the maximum signal intensity of the superficial temporal artery on TOF-MRA was calculated by using the following formula: (Postoperative Ipsilateral/Postoperative Contralateral)/(Preoperative Ipsilateral/Preoperative Contralateral).
  
  
  
  Of 23 patients (26 sides) who underwent the operation, 5 sides showed cerebral hyperperfusion syndrome postoperatively. There was a significant difference in the change ratio of signal intensity on TOF-MRA observed between the cerebral hyperperfusion syndrome and non-cerebral hyperperfusion syndrome groups (cerebral hyperperfusion syndrome group: 1.88 ± 0.32; non-cerebral hyperperfusion syndrome group: 1.03 ± 0.20; P = .0009). The minimum ratio value for the cerebral hyperperfusion syndrome group was 1.63, and the maximum ratio value for the non-cerebral hyperperfusion syndrome group was 1.30. Thus, no overlap was observed between the 2 groups for the change ratio of signal intensity on TOF-MRA.
  
  
  
  Diagnosis of cerebral hyperperfusion syndrome is indicated by an increase in the change ratio of signal intensity on TOF-MRA by more than approximately 1.5 times the preoperative levels.
authors.affiliation: From the Departments of Neurosurgery (K.S., M.Y., H.K., D.Y., K.F., T.K.) kimitoshi@k8.dion.ne.jp.
authors.forename: K
authors.identifier: 0000-0003-4104-722X
authors.initials: K
authors.lastname: Sato
authors.affiliation: From the Departments of Neurosurgery (K.S., M.Y., H.K., D.Y., K.F., T.K.).
authors.forename: M
authors.identifier: 0000-0003-2008-0901
authors.initials: M
authors.lastname: Yamada
authors.affiliation: From the Departments of Neurosurgery (K.S., M.Y., H.K., D.Y., K.F., T.K.).
authors.forename: H
authors.identifier: 0000-0003-0503-0762
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: From the Departments of Neurosurgery (K.S., M.Y., H.K., D.Y., K.F., T.K.).
authors.forename: D
authors.identifier: 0000-0002-6832-2511
authors.initials: D
authors.lastname: Yamamoto
authors.affiliation: Diagnostic Radiology (Y.A., Y.I.), Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Y
authors.identifier: 0000-0002-9138-4219
authors.initials: Y
authors.lastname: Asano
authors.affiliation: Diagnostic Radiology (Y.A., Y.I.), Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Y
authors.identifier: 0000-0001-7250-8303
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: From the Departments of Neurosurgery (K.S., M.Y., H.K., D.Y., K.F., T.K.).
authors.forename: K
authors.identifier: 0000-0001-7760-9787
authors.initials: K
authors.lastname: Fujii
authors.affiliation: From the Departments of Neurosurgery (K.S., M.Y., H.K., D.Y., K.F., T.K.).
authors.forename: T
authors.identifier: 0000-0002-1507-6214
authors.initials: T
authors.lastname: Kumabe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery*; D009072:Moyamoya Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D064847:Multimodal Imaging; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology; D013699:Temporal Arteries / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult