AbstractMoyamoya disease (MMD) suffers from impaired cerebrovascular hemodynamics and high perioperative complications occurrence. This study aims to propose and evaluate the relationship between intraoperative hemodynamics and perioperative complications, and propose a potential compensatory self-recirculation network in MMD.

烟雾病（MMD）患有脑血管血流动力学受损和围手术期并发症发生率高。本研究旨在提出和评估术中血流动力学与围手术期并发症之间的关系，并提出MMD中潜在的代偿性自循环网络。

We prospectively enrolled 63 MMD patients undergone combined revascularization, and patients were divided into decreased and increased group according to decreased and increased microvascular transit time (MVTT), respectively. Mean age of all patients was 45.9 ± 9.4 years. The post-bypass hyperperfusion syndrome occurrence was significantly higher in the decreased MVTT group, and the cerebral infarction occurrence was significantly higher in the increased MVTT group.

我们前瞻性招募了63例接受联合血运重建的MMD患者，根据微血管通过时间（MVTT）的减少和增加将患者分为减少组和增加组。所有患者的平均年龄为45.9±9.4岁。MVTT降低组的旁路术后高灌注综合征发生率显着较高，MVTT升高组的脑梗死发生率显着较高。

For the hemodynamics of the recipient artery around anastomosis, the parameters of distal site demonstrated a significant higher intensity and shorter time in the decreased MVTT group, while the parameters of the proximal site demonstrated a significant higher intensity and shorter time in the increased MVTT group.

对于吻合口周围受体动脉的血流动力学，远端部位的参数在MVTT降低组中显示出显着更高的强度和更短的时间，而近端部位的参数在MVTT增加组中显示出显着更高的强度和更短的时间。

Pre-bypass and post-bypass collision of blood flow in artery and vein were firstly observed and illustrated. Intraoperative hemodynamics showed close relationship with perioperative complications. The blood flow of MMD seems to develop a unique compensatory self-recirculation system and contribute to the clinical complications, providing a new insight to the clinical management the pathology of the disease..

首先观察并说明了旁路前和旁路后动脉和静脉血流的碰撞。术中血流动力学与围手术期并发症密切相关。MMD的血流似乎发展出独特的补偿性自我再循环系统，并导致临床并发症，为临床管理提供了新的见解-疾病的病理学。。

IntroductionMoyamoya disease (MMD) is a chronic cerebrovascular disease characterized by progressive stenosis of the terminal internal carotid arteries and their proximal branches1. The detailed pathogenesis of MMD is still not fully understood. The moyamoya, Japanese for 'puff of smoke,' refers to the appearance on cerebral angiography of an abnormal collateral vascular network at the base of the brain2.

引言烟雾病（MMD）是一种慢性脑血管疾病，其特征是终末颈内动脉及其近端分支进行性狭窄1。MMD的详细发病机制尚不完全清楚。moyamoya在日语中是“一团烟”的意思，是指在脑血管造影中出现的大脑底部异常的侧支血管网络2。

Moyamoya-associated collaterals are generally dilated perforating arteries that are believed to be a combination of preexisting and newly developed vessels3,4. Suzuki’s angiographic grading system divided the moyamoya vessels into six stages, indicating the chronological order of the compensatory reorganization process around Willis’ circle2.

烟雾相关的侧支通常是扩张的穿孔动脉，被认为是先前存在的和新开发的血管的组合3,4。铃木（Suzuki）的血管造影分级系统将烟雾病血管分为六个阶段，表明围绕威利斯环的补偿性重组过程的时间顺序2。

Meanwhile, blood flow reduction in the major cerebral anterior circulation leads to compensatory development of collateral vasculature in the brain parenchyma and on the surface of the brain. This reorganization involves small vessels near the apex of the carotid, on the cortical surface, leptomeninges, and branches of the external carotid artery5,6,7.

同时，主要脑前循环的血流减少导致脑实质和大脑表面侧支血管的代偿性发育。这种重组涉及颈动脉顶点附近的小血管，皮质表面，软脑膜和颈外动脉分支5,6,7。

The collateral pathway formed in the brain serves as a unique vascular network. Therefore, we hypothesized that MMD exhibits a distinct, undescribed cerebrovascular circulation network with its own blood flow redistribution.Surgical treatment is the most effective method. Hemodynamic alteration has been detected using FLOW8008,9,10 and Color Doppler Ultrasonography (CDUS)11,12.

大脑中形成的侧支通路是一个独特的血管网络。因此，我们假设MMD表现出一个独特的，未描述的脑血管循环网络，并具有自身的血流重新分布。手术治疗是最有效的方法。使用FLOW8008,9,10和彩色多普勒超声（CDUS）11,12检测血流动力学改变。

However, the mechanism of hemodynamic alteration on the function remains unclear. The correlation between reduction in the microvascular transit time (MVTT) and post-bypass hyperperfusion syndrome (HPS) was explored and significantly decreased MVTT after bypass was found13. In our work, on the contrary, we ob.

然而，血流动力学改变对功能的机制仍不清楚。探讨了微血管通过时间（MVTT）减少与旁路术后高灌注综合征（HPS）之间的相关性，发现旁路术后MVTT显着降低13。相反，在我们的工作中，我们观察到。

Data availability

数据可用性

Data is provided within the manuscript.

数据在手稿中提供。

AbbreviationsMMD:

缩写MMD：

Moyamoya disease

烟雾病

CDUS:

Color Doppler Ultrasonography

彩色多普勒超声检查

MVTT:

MVTT:

The microvascular transit time

微血管通过时间

HPS:

HPS：

Post-bypass hyperperfusion syndrome

旁路术后高灌注综合征

BFI:

BFI公司：

Blood flow index

血流指数

CBF:

CBF公司：

Cerebral blood flow

脑血流量

ICG:

ICG：

Indocyanine green

吲哚菁绿

STA-MCA:

STA-MCA：

Superficial temporal artery to middle cerebral artery

颞浅动脉至大脑中动脉

EDAS:

EDAS：

Encephalo-duro-arterio-synangiosis

脑-硬-动脉-合成血管病

MRI:

MRI：

Magnetic resonance imaging

磁共振成像

MRA:

MRA：

Magnetic resonance angiography

磁共振血管造影

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Fujimura，M。＆Tominaga，T。成人烟雾病联合血运重建手术后急性期脑血流动力学变化的特征模式：N-异丙基-p-[（123）I]碘安非他明单光子发射计算机断层扫描研究。在脑血管手术和干预的趋势中，G。

Esposito, L. Regli, M. Cenzato, Y. Kaku, M. Tanaka, and T. Tsukahara, eds. (Springer Copyright 2021, The Author(s).), pp. 57–61. https://doi.org/10.1007/978-3-030-63453-7_8 (2021).Download referencesAcknowledgementsWe thank Mrs. Tian and Mrs. Huang for helping to collect the intraoperative data.Author informationAuthors and AffiliationsDepartment of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No.

Esposito，L。Regli，M。Cenzato，Y。Kaku，M。Tanaka和T。Tsukahara编辑（Springer Copyright 2021，作者），第57-61页。https://doi.org/10.1007/978-3-030-63453-7_8（2021年）。下载参考文献致谢我们感谢田女士和黄女士帮助收集术中数据。作者信息作者和附属机构郑州大学第一附属医院神经外科，No。

1 Jianshe East Road, Erqi District, Zhengzhou City, 45000, Henan Province, ChinaLei Cao, Yang Dong, Zeming Wang, Mengguo Guo, Dongpeng Li, Hao Wang, Lingyun Zhu, Bo Yang & Hongwei LiDepartment of Hematology, Henan Provincial People’s Hospital, Zhengzhou, 450003, Henan Province, ChinaXiaoli YuanAuthorsLei CaoView author publicationsYou can also search for this author in.

中国河南省郑州市二七区建设东路1号曹磊，杨东，王泽明，郭孟国，李东鹏，王浩，朱凌云，杨波，洪伟，河南省人民医院血液科，河南郑州，450003，袁晓丽作者雷曹维作者出版物你也可以在中搜索这位作者。

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PubMed Google ScholarContributionsConceptualisation: Lei Cao, Bo Yang, Hongwei Li; Data Curation: Lei Cao, Xiaoli Yuan, Lingyun Zhu; Formal Analysis: Yang Dong, Zeming Wang, Mengguo Guo; Methodology: Yang Dong, Zeming Wang, Mengguo Guo; Resources: Xiaoli Yuan, Lingyun Zhu; Visualisation: Dongpeng Li, Hao Wang; Supervision: Bo Yang, Hongwei Li; Writing—Original Draft: Lei Cao, Xiaoli Yuan; Writing—Review & Editing: Bo Yang, Hongwei Li.Corresponding authorsCorrespondence to.

PubMed谷歌学术贡献概念：曹磊，杨波，李洪伟；数据管理：曹磊，袁晓丽，朱凌云；形式分析：杨东，王泽明，郭孟国；方法论：杨东，王泽明，郭梦国；资源：袁晓丽，朱凌云；可视化：李东鹏，王浩；监督：Bo Yang，Hongwei Li；撰写原稿：曹磊，袁晓丽；。

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Reprints and permissionsAbout this articleCite this articleCao, L., Yuan, X., Dong, Y. et al. Cerebral hemodynamic plasticity related to potential compensatory self-recirculation network in Moyamoya disease: an observational study.

转载和许可本文引用本文Cao，L.，Yuan，X.，Dong，Y。等人。与烟雾病潜在代偿性自我再循环网络相关的脑血流动力学可塑性：一项观察性研究。

Sci Rep 14, 26059 (2024). https://doi.org/10.1038/s41598-024-75058-0Download citationReceived: 23 July 2024Accepted: 01 October 2024Published: 30 October 2024DOI: https://doi.org/10.1038/s41598-024-75058-0Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

科学报告1426059（2024）。https://doi.org/10.1038/s41598-024-75058-0Download引文接收日期：2024年7月23日接受日期：2024年10月1日发布日期：2024年10月30日OI：https://doi.org/10.1038/s41598-024-75058-0Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsMoyamoya diseaseHemodynamicsSelf-recirculation networkPerioperative complicationFLOW800

关键词烟雾病血流动力学自循环网络围手术期并发症流程800