Hemodynamic Alterations of Carotid Siphons after Revascularization is Associated with Outcomes in Moyamoya Angiopathy: A 4D Flow MRI Study

Motivation: Current evidence is insufficient to help better understand the interactions between hemodynamics of carotid siphons in moyamoya angiopathy (MMA) and outcomes of revascularization. Goal(s): To evaluate hemodynamic alterations of carotid siphons after revascularization for MMA using 4D Flow MRI and to explore its association with outcomes. Approach: MMA patients receiving revascularization were prospectively enrolled. We used VesselExplorer2 software to analyze 4D Flow MRI data and measure hemodynamic parameters of carotid siphons. Relationships between hemodynamic parameters of carotid siphons and surgical outcomes were explored. Results: Flowmean and Flowmax of bilateral ICAs in MMA decreased at follow-up, which was associated with outcomes of revascularization surgery. Impact: We identified new hemodynamic parameters that might be used to predict the prognosis of MMA. 4D Flow MRI is a promising tool for quantitatively detecting hemodynamics in intracranial vessels of MMA patients, providing valuable hemodynamic parameters for evaluating surgical outcomes.