Cerebral hyperperfusion (CHP) occurred frequently after direct superficial temporal artery–middle cerebral artery (STA-MCA) bypass surgery for moyamoya disease (MMD). We analyzed cortical microvascular density (CMD) and the change of cerebral blood flow (LΔCBF) using intraoperative laser speckle contrast imaging (LSCI) on 130 hemispheres of 95 consecutive adult patients with MMD. The demographic characteristics, cortical hemodynamic sources, bypass methods, intraoperative blood flow data, and relative CBF changes on single-photon emission computed tomography (SPECT) examination (SΔrCBF) were compared between the groups with and without CHP. The median values for CMD, LΔCBF, and SΔrCBF were significantly higher in the CHP group than in the non-CHP group (CMD 0.240 vs 0.206, P = 0.004; LΔCBF 2.285 vs 1.870, P < 0.001; SΔCBF 1.535 vs 1.260, P < 0.001). Multivariate analysis revealed that hemodynamic sources of recipient parasylvian cortical arteries from MCA (M-PSCAs), end-to-side (E-S) bypass method, CMD ≥ 0.217, and LΔCBF ≥ 1.985 were the risk factors for CHP. Intraoperative LSCI was useful for evaluating hemodynamics and predicting CHP in patients with MMD.

中文翻译：

---

术中激光散斑对比成像评估局部脑血流动力学变化预测成年烟雾病患者 STA-MCA 搭桥术后脑过度灌注

烟雾病（MMD）直接颞浅动脉-大脑中动脉（STA-MCA）搭桥手术后经常发生脑过度灌注（CHP）。我们使用术中激光散斑对比成像 (LSCI) 对 95 名连续成年 MMD 患者的 130 个半球进行了皮层微血管密度 (CMD) 和脑血流量 (LΔCBF) 的变化分析。比较有和没有 CHP 组之间的人口特征、皮质血流动力学来源、旁路方法、术中血流数据以及单光子发射计算机断层扫描 (SPECT) 检查 (SΔrCBF) 的相对 CBF 变化。CHP 组的 CMD、LΔCBF 和 SΔrCBF 中值显着高于非 CHP 组（CMD 0.240 vs 0.206，P = 0.004；LΔCBF 2.285 vs 1.870，P < 0.001；SΔCBF 1.535 vs 1.260，P < 0.001）。多变量分析显示，血流动力学来源为MCA（M-PSCAs）的受者侧裂皮质动脉、端侧（ES）旁路法、CMD≥0.217、LΔCBF≥1.985是CHP的危险因素。术中 LSCI 对于评估 MMD 患者的血流动力学和预测 CHP 非常有用。