Correlation between enlarged perivascular space and cerebral venous reflux in recent small subcortical infarcts within the lenticulostriate artery territory / 中华神经科杂志

Objective:To summarize the incidence of cerebral venous reflux (CVR) in patients with recent small subcortical infarct (RSSI) and explore its correlation with enlarged perivascular spaces (EPVS).Methods:Patients with RSSI in the lenticulostriate artery admitted to the Department of Neurology of the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2022 were included. The baseline demographic data, medical history, and laboratory results of the patients were collected. CVR was assessed by time-of-flight magnetic resonance angiography. Patients were stratified into 2 groups based on the presence (CVR group) or absence of CVR (non-CVR group), and baseline characteristics as well as laboratory test results were compared between the 2 groups. The location and number of EPVS were evaluated using a visual grading scale, with EPVS with higher scores defined as high-grade EPVS (HEPVS). Simultaneous evaluation of cerebral white matter hyperintensities and lacunar infarctions was conducted, followed by intergroup comparisons. The relationship between EPVS and CVR was studied using multiple Logistic regression analysis.Results:A total of 571 patients with RSSI in the lentiform artery area were ultimately included, including 180 females (31.5%). Their age was (59.37±12.87) years. Among them, 73 patients (12.8%) exhibited CVR based on imaging findings, so the incidence of CVR was 12.8%. In comparison between the CVR group ( n=73) and the non-CVR group ( n=498), the proportion of females [21.9% (16/73) vs 32.9% (164/498), χ 2=3.578, P=0.059] was lower and the proportion of history of smoking [38.4% (28/73) vs 27.7% (138/498), χ 2=3.499, P=0.061] was higher in the CVR group, but without statistical significance. Additionally, the history of alcohol consumption [34.2% (25/73) vs 21.7% (108/498), χ 2=5.621, P=0.018] and the proportion of patients with concomitant HEPVS in the basal ganglia area [41.1% (30/73) vs 25.3% (126/498), χ 2=7.999, P=0.005] was higher in the CVR group with statistical significance. Multiple Logistic regression analysis showed that HEPVS in the basal ganglia region remained independently associated with CVR ( OR=1.988, 95% CI 1.190-3.320, P=0.009). Conclusion:EPVS in the basal ganglia region is significantly associated with CVR in the RSSI population, suggesting that venous dysfunction may be closely related to the formation of EPVS.

Clinical characteristics and prognosis of posterior reversible encephalopathy syndrome with spinal cord involvement / 中华神经科杂志

Objective:To investigate the clinical manifestations, imaging features and prognosis of posterior reversible encephalopathy syndrome with spinal cord involvement (PRES-SCI).Methods:The clinical data of 1 patient with PRES-SCI admitted to the Department of Neurology of the First Affiliated Hospital of Zhengzhou University in November 2021 were analyzed, and the data of 38 patients with PRES-SCI reported in domestic and foreign databases and this patient were collected for pooled analysis.Results:The main clinical manifestations of 39 PRES-SCI patients (including this patient) included headache (79.5%, 31/39), visual disturbance (79.5%, 31/39), vomiting (46.2%, 18/39), disturbance of consciousness (38.5%, 15/39), limb weakness (28.2%, 11/39) and seizure (23.1%, 9/39). There were up to 97.4% (38/39) of patients who had significantly elevated blood pressure. The imaging feature was long-segment spinal cord lesion involving central gray matter. Approximately 89.7% (35/39) of the spinal cord lesions originated from the junction of the medulla oblongata and the cervical spinal cord. The median number of abnormal spinal cord segments corresponding to the vertebral body was 9 (the shortest was 4 and the longest was the entire spinal cord). Thirty-eight patients had brain lesions, and the most frequently involved sites were medulla oblongata (82.1%, 32/39), occipital lobe (46.2%, 18/39), pons (43.6%, 17/39), parietal lobe (41.0%, 16/39), and cerebellum (38.5%, 15/39). Among 38 patients completing the follow-up, 31 patients (81.6%) were clinically recovered.Conclusions:Posterior reversible encephalopathy syndrome could involve the spinal cord. For patients with long-segment spinal cord lesions and significantly increased blood pressure or other risk factors, PRES-SCI should be considered. Timely identification and treatment could make most patients recovery.

Morphological alterations study in the Golgi apparatus of skin fibroblasts in spinocerebellar ataxia type 3 patients / 中华神经科杂志

Objective:To identify the morphological alterations in the Golgi apparatus of skin fibroblasts in spinocerebellar ataxia type 3 (SCA3) patients.Methods:In this study, 3 SCA3 patients and 3 healthy volunteers were obtained in the First Affiliated Hospital of Zhengzhou University from 2016 to 2020. The cytosine, adenine, and guanine repeats of 3 SCA3 patients were 14/76, 20/80 and 21/82, respectively. Tissue mass culture was used to amplify skin fibroblasts derived from SCA3 patients and healthy volunteers. Cell viability and apoptosis were detected using cell counting kit-8 assay and flow cytometry, respectively. Western blotting and immunofluorescence assay were used to detect the protein expression of ataxin-3, Golgi reassembly stacking protein 2 (GORASP2), and Golgi matrix protein 130 (GM130) in the skin fibroblasts. The morphology of the Golgi apparatus in skin fibroblasts was detected using transmission electron microscopy.Results:Tissue culture of skin fibroblasts of both SCA3 patients and healthy volunteers was successfully established. The patient-derived dermal fibroblasts expressing mutant ataxin-3 protein exhibited reduced cell viability ( t=5.06,P=0.007), increased apoptosis ( t=3.77, P=0.020), fragmentation of the Golgi apparatus, increased expression of GM130 ( t=5.23, P=0.006), and decreased expression of GORASP2 ( t=4.35, P=0.012). Transmission electron microscopy revealed that the Golgi apparatus was disorganized in skin fibroblasts. Conclusion:Fragmentation of the Golgi apparatus occurs in the skin fibroblasts of SCA3 patients, and abnormal morphology and structure of the Golgi apparatus may be involved in the pathogenesis of SCA3.

Influences of Oral Undenatured Collagen Type Ⅱ on Knee Joint Range of Motion in Patients with Knee Osteoarthritis / 医用生物力学

Objective To evaluate the effects of oral undenatured collagen type Ⅱ on rehabilitation of knee osteoarthritis. Methods Sixteen patients with levelⅠand Ⅱ knee osteoarthritis (KOA) were recruited in this study. The WOMAC questionnaire was used to measure the symptoms of knee joint in patients. The KneeKG 3D evaluation system was used to measure the kinematics characteristics of the knee joints. The pair t-test was applied to analyze the differences in knee kinematics after taking undenatured collagen type Ⅱ for 3 months. Results After taking undenatured collagen type Ⅱ, the patient’s feeling of knee joint pain, stiffness, and the difficulty of daily life was reduced. In addition, the knee flexion angle increased from 51.8°±15.2° to 58.4°±10.7° (P<0.05), and the knee varus angle decreased to 2.1°±4.8°. The improvement rate of knee varus was 82%. Conclusions Taking undenatured collagen type Ⅱ for 3 months could play a role in rehabilitation for patients with early KOA. The knee range of motion was close to the level of healthy elderly people, thus improving the symptoms of knee varus.

Skin nerve phosphorylated α synuclein deposits in patients with Parkinson′s disease / 中华神经科杂志

Objective:To investigate the characteristics of phosphorylated α-synuclein (p-α-syn) deposition in skin nerve fibers and its potential as a peripheral biomarker for Parkinson′s disease (PD).Methods:Fifteen PD patients and 31 age-matched healthy controls were evaluated by Small-Fiber Neuropathy and Symptoms Inventory Questionnaire (SFN-SIQ), who were recruited in the Department of Neurology, the First Affiliated Hospital of Zhengzhou University from June 1, 2017 to August 31, 2018. PD patients were divided into two subgroups according to the main clinical manifestations: bradykinesia ( n=7) and resting tremor ( n=8), and the severity of the disease was evaluated by Honhn-Yahr classification, where 0 to 2.5 indicates early stage ( n=11) and 3.0 to 5.0 indicates middle to late stage ( n=4). Three-millimeter punch biopsies were taken from cervical seven paravertebral area and distal leg of PD patients, while the skin of the distal leg of healthy control group was only taken, followed by immunohistochemistry and double immunofluorescence staining. The intraepidermal nerve fiber density (IENFD) and the deposition characteristics of p-α-syn were studied. Results:P-α-syn immuosignals were observed in 12/15 PD patients while in none of the control subjects, distributed in shape of dots or thread in the subepithelial plexus, dermis nerve tracts, and/or in the nerve fibers innervating sweat gland, muscle arrector pilorum, small blood vessels or hair follicle. The positive rate of p-α-syn deposition in a single site was 6/15 of the distal leg, 7/15 of the cervical, and the total positive rate was 12/15. The IENFD of PD group was 6.85±1.94/mm, which was significantly lower than that of control group (10.45±3.70/mm, t=-3.303, P=0.002), and was negatively correlated with the SFN-SIQ ( r=-0.561, P=0.046). There was no statistically significant difference in the positive rate of p-α-syn deposition and IENFD between patients with tremor and bradykinesia, nor between patients at stage of Hoehn-Yahr 0-2.5 and 3.0-5.0. Conclusions:Cutaneous p-α-syn deposits in the nerve fibers of PD patients, with a significant decrease in IENFD. P-α-syn deposition in skin nerves may be an intrinsic peripheral pathological change of PD, and skin biopsy immunolabelling p-α-syn merits further study as a potential peripheral biomarker of in vivo PD diagnosis.

Preliminary mechanism study on the X-linked parkinsonism caused by RAB39B gene mutation c.536dupA / 中华神经科杂志

Objective:To detect the expression level of RAB39B gene and the effect of RAB39B on autophagy and α-synuclein, and then investigate the role of RAB39B gene mutation c.536dupA in the pathogenesis of Parkinson′s disease.Methods:Based on the novel RAB39B gene c.536 dupamutation identified in the previous work, the recombinant expression plasmid (pcDNA3.1-HA-RAB39B-536) of RAB39B gene with this mutation and wild-type recombinant expression plasmid (pcDNA3.1-HA-RAB39B) of RAB39B gene were constructed, and the recombinant expression plasmid was transfected into N2a cells with liposome as experimental group. The control group was made up with N2a cells transfected with plasmid pcDNA3.1-HA-RAB39B. Real-time polymerase chain reaction, Western blotting, immunofluorescence and immunoprecipitation techniques were used to detect the expression level of mutant RAB39B gene and the effects of RAB39B on autophagy and α-synuclein.Results:In the N2a cell model, the transcription level of mutant RAB39B was about twice that of wild type RAB39B, while the protein level of mutant RAB39B (0.30±0.00) was significantly lower than that of wild type (1.50±0.25, t=8.313, P<0.05). After adding proteasome inhibitor MG132, the protein level of mutant RAB39B increased (0.70±0.10, t=6.925, P<0.05); the level of microtubule-associated protein 1 light chain 3 BⅡ/Ⅰ of mutant RAB39B (3.11±0.30) was significantly lower than that of wild type (7.03±0.20, t=18.831, P<0.05); overexpression of wild type and mutant RAB39B did not affect the level of endogenous α-synuclein; overexpression of wild-type RAB39B resulted in elevated level of exogenous wild-type (p.A53T; from 0.60±0.11 to 1.25±0.08, t=8.254, P<0.05) and mutant (from 0.55±0.08 to 1.15±0.08, t=9.293, P<0.05) α-synuclein. Conclusions:The stability of the RAB39B protein decreased with the appearance of c.536 dupA mutation, the mutant protein may be degraded through the ubiquitin-proteasome pathway, and this mutation may affect the autophagy level of cells. RAB39B protein may interact with α-synuclein in vivo and may be involved in the maintenance of the stable level of α-synuclein.

Analysis of a Chinese family with distal hereditary motor neuropathy type V / 中华神经科杂志

Objective:To report the clinical, electrophysiological and genetic features in a Chinese family with distal hereditary motor neuropathy type V (dHMN-V) and screen the pathogenic mutant gene.Methods:A family with the history of inherited peripheral neuropathy was recruited in the First Affiliated Hospital of Zhengzhou University in July 2017. The clinical features and electrophysiological data were investigated. Genetic testing on well-established genes associated with hereditary peripheral neuropathy was conducted by targeted high throughput sequencing and the candidate variant was screened in the family and normal controls.Results:There were four affected individuals in the family. The proband, a 25-year-old male, was characterized by weakness and atrophy in the distal extremities primarily affected the upper extremities without sensory impairment. Electrophysiological study showed chronic neurogenic pattern in the upper and lower limb muscles. The motor conduction showed reduced velocity and compound muscle action potential amplitude, while the sensory conduction studies results were normal. The grandfather, a maternal uncle and a cousin of the proband exhibited similar clinical manifestations and electrophysiological abnormality. Genetic testing revealed a heterozygous mutation, c.880G>A(p.G294R), in the GARS gene in the proband. Proband′s mother and two other affected individuals carried the mutation which was confirmed by Sanger sequencing. The mutation site was not found in the unaffected members from the family and 300 unrelated normal controls. The variant is a novel mutation which has not been reported in dbSNP, ExAC and 1000 Genomes Project databases. Conclusion:The results suggest that the novel c.880G>A(p.G294R) mutation of the GARS gene is responsible for the Chinese patients with dHMN-V, and the findings broaden the mutational spectrum of GARS gene.

Recent advance in early diagnosis biomarkers of Creutzfeldt-Jakob disease / 中华神经医学杂志

Creutzfeldt-Jakob disease is a type of fatal central nervous system degeneration caused by infectious pathogenic prion protein. The early clinical manifestations of the disease are diverse and lack of specificity, so it is difficult to distinguish it from other neurological diseases. Researchers have made long-term exploration and clinical applications in imaging, electroencephalography, and detection of special proteins in cerebrospinal fluid of patients with Creutzfeldt-Jakob disease. In recent years, the development of new methods for the detection of pathogenic prion protein has provided great help for the early diagnosis of the disease, and it has great clinical application prospects. This article reviews the current research on the epidemiology, etiology and pathological mechanism and early diagnosis biomarkers of Creutzfeldt-Jakob disease, in order to help clinical colleagues to further enhance the understanding of Creutzfeldt-Jakob disease.

A case of unilateral hypertrophic olivary degeneration following bilateral medial medullary infarction / 中华神经科杂志

Bilateral medial medullary infarction is a rare type of stroke. Hypertrophic olivary degeneration (HOD) is usually secondary to the lesion involving the Guillain-Mollaret triangle with vacuolar degeneration of inferior olivary nucleus neurons and enlargement of inferior olivary nucleus. The primary lesions involving the Guillain-Mollaret triangle are usually located in midbrain, pons and cerebellum. A case of unilateral HOD secondary to bilateral medial medullary infarction is reported and the clinical characteristics, diagnosis and treatment are analyzed in order to improve the understanding of HOD.

The complications of the Pipeline embolization device in treating complex cerebral aneurysm / 中华放射学杂志

Objective To evaluate the complications of the Pipeline embolization device in treating complex cerebral aneurysm. Methods Consecutive data of 53 patients who suffered from complex cerebral aneurysm and underwent Pipeline device treatment were retrospectively collected and analyzed. Clinical and imaging data including aneurysm location, type, size and the using of coils, were recorded to investigate the complications. Results Pipeline embolization device was successfully implanted, and 27 patients were combined with coils. Five complications occurred in the 1-month perioperative stage, of which, 1 was disable and 1 was fatal. Two non-disability complications occurred in the later stage beyond 1 month, of which, 1 was cerebral infraction and 1 was intraparenchymal hemorrhage. The Logistic regression analysis demonstrated that the posterior circulation location, types, large size and the using of coils were not statistically significant risk factors for complications. The median imaging follow-up for 43 patients with 58 aneurysms was 6 months, the complete and sub-complete occlusion rate of aneurysms was 74.1％ (43 / 58) and 3 non-symptomatic stenosis occurred in the patients with Pipeline embolization device. Conclusions The occlusion rate of Pipeline embolization device in treating Chinese complex cerebral aneurysm is high , but another further research should be done for the mechanism and the prevention methods of the complications.

Overall burden of cerebral small vessel disease imaging and stroke outcomes / 国际脑血管病杂志

Cerebral small vessel disease (CSVD) is an imaging and clinical syndrome caused by intracranial small vessel lesions.Studies have confirmed that CSVD is closely associated with the stroke outcomes.The overall burden is a concept based on a single imaging marker of CSVD,which can comprehensively reflect the severity of brain injury and identify high-risk stroke patients.This article reviews the correlation between the overall burden of the CSVD imaging and the stroke outcomes.

IL-33/ST2 system: therapeutic target of ischemic stroke / 国际脑血管病杂志

Inflammation response is an important pathological process of neuronal cell death after stroke.Interleukin (IL)-33/ST2 system is involved in the inflammatory response process of ischemic stroke and has been proved to be a protective factor.This article reviews the role and mechanism of IL-33/ST2 system in the regulation of immune inflammation after ischemic stroke.

Serum biomarkers of unstable carotid plaque / 国际脑血管病杂志

Carotid atherosclerosis,especially unstable carotid plaque,is closely related to stroke.Serum biomarkers have unique value for screening and identifying high-risk carotid plaque.This article reviews the serum biomarkers of unstable carotid plaque.

rs12122341 polymorphism is not associated with risk of ischemic stroke in Chinese Han population / 国际脑血管病杂志

Objective To investigate correlation between the rs12122341 polymorphism and ischemic stroke and its major subtypes in Chinese Han population.Methods The patients with ischemic stroke and matched healthy controls in Chinese Han population were enrolled.The rs12122341 genotype was detected by the improved multiple ligase detection reaction (iMLDR).Results A total of 776 patients with ischemic stroke (415 large artery atherosclerotic stroke and 361 small artery occlusive stroke) and 776 healthy controls were enrolled.Genotyping showed that only rs12122341 CC and CG genotypes were detected in all subjects,and no GG genotype was detected.There was no significant difference in frequencies of allele and genotype between the patient group and the control group.Multivariate logistic regression analysis showed that there were no significant correlations between rs12122341 polymorphism and ischemic stroke (odds ratio [OR] 1.482,95％ confidence interval [CI]0.641-3.421;P =0.447),large artery atherosclerotic stroke (OR 1.972,95％ CI 0.655-6.034;P=0.227),and small arterial occlusive stroke (OR 1.632,95％ CI 0.437-6.262;P =1.000).Conclusions There is no significant correlation between the rs12122341 polymorphism and risk of ischemic stroke and its major subtypes in Chinese Han population.

Literature Analysis of 2 636 Cases of Adverse Drug Reaction Induced by Tetanus Antitoxin / 中国药房

OBJECTIVE:To investigate general regularity and characteristics of tetanus antitoxin (TAT) induced by ADRs,in order to provide reference for rational drug use in the clinic.METHODS:Domestic and foreign literatures on ADRs induced by TAT were retrieved,and related information of 2 636 case of ADR were analyzed statistically.RESULTS:Among patients whose gender and age were recorded,male with ADR induced by TAT was more than female,mainly aged 15-35 years old,accounting for 70.32 ％ (289/411);28.28 ％ (56/198) used water for injection;ADR occurred within 30 min after medication in 5.84％ (154/2 636)cases;main ADR were lesion of skin and its appendents,circulatory system damage,systemic reaction damage.Main clinical manifestations were urticaria,rash,chest tightness and anaphylaetic shock,etc.Ten cases died and 7 cases had sequelae;the rest were all recovered and cured after symptomatic treatment.CONCLUSIONS:TAT has a higher proportion of allergic reactions,especially anaphylactic shock,but great importance should be attached to rare auditory and vestibular dysfunction,visual impairment,elevated white blood cell count and other ADR.It is suggested to strengthen medication monitoring and used drugs strictly in accordance with drug package inserts so as to promote rational drug use.

Study on Signal Detection of Xiyanping Injection-induced Urticaria Based on BCPNN Warning Technology / 中国药房

OBJECTIVE:To explore and analyze signals of Xiyanping injection-induced urticaria from spontaneous reporting system database of Jiangxi province. METHODS:The continuous ADR report monitoring data were collected from spontaneous re-porting system of Jiangxi province,and established database. Bayesian confidence propagation neural network(BCPNN) method was used to calculate information component,IC value of Xiyanping injection-induced urticaria. The year-to-year changes of IC val-ue and its interval were analyzed. RESULTS:A total of 328324 ADR reports were collected in Jiangxi province during 2004-2016. The IC value of Xiyanping injection-induced urticaria detected by BCPNN method was 1.10(the lower limit of IC value was 0.65, and upper limit was 1.54),i.e. there was signal and the IC value ranged from-0.87 to 1.65. CONCLUSIONS:The results of BCPNN method suggest that urticaria is a warning signal of Xiyanping injection. The risk is increasing gradually,and prediction precision increase with the addition of report quantity.

Fluid-attenuated inversion recovery vascular hyperintensities in acute ischemic stroke / 国际脑血管病杂志

Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is a common magnetic resonance imaging findings in acute ischemic stroke due to severe stenosis or occlusion of large cerebral arteries.This article reviews the applications and related research of FVH in patients with acute ischemic stroke.

Clinical and genetic analyses of 3 pedigrees with hereditary spastic paraplegia / 中华神经医学杂志

Objective To analyze the clinical manifestations and genetic mutations in 3 pedigrees with hereditary spastic paraplegia (HSP).Methods Three pedigrees diagnosed as having HSP in our hospital from January 2014 to November 2015,were chosen;the clinical manifestations,electrophysiology and imaging features of the patients in these three families were analyzed.Genomic DNA was extracted from peripheral venous blood,and the targeted gene capturing was employed to identify the disease-causing genes of these patients.Results The patients from the first family was familiar HSP,and the main clinical features were progressive lower limbs weakness and abnormal gait without cognitive impairment;the patients from the second family were familiar HSP and those from the third family were HSP without family history,and the main clinical features of the two pedigrees were slowly progressive spastic paraplegia and cognitive impairment.In addition,thin corpus callosum was visible in MR imaging of family three.Genetic testing showed the first family presented with a known mutation c.715C＞T ofA TL1 exon 7 and the loci co-segregated in the family.The second family presented with novel compound heterozygous mutations in the SPG11 gene:c.3099_3103delGTTTG mutation of exon 17and c3817 3818insTGA mutation of exon 22;novel compound heterozygous mutations in the SPG11 gene in the third family were detected as follows:c.6194C ＞G mutation of exon 32 and c.5121+1C＞T splicing mutation ofintro 29.Conclusions Four novel mutations in SPG11 gene and one known mutation in A TL1 gene are found,which enriches the known HSP mutation types.Targeted gene capture is an efficient and rapid tool for identifying the causation of some complex and genetically heterogeneous neurodegenerative diseases.

Recent advance in microglial cell drug modulation in ischemic stroke / 中华神经医学杂志

The etiology underlying ischemic stroke is still elusive. Previous studies have indicated that inflammation might play a key role in the pathogenesis, which provided a novel insight into the therapeutic strategy of ischemic stroke. In this review, we summarize some drugs which regulate the activation and polarization of microglia and further alleviate neurological symptoms.

Value of high-resolution magnetic resonance imaging in differential diagnoses of moyamoya disease and vasculitis-related moyamoya syndrome / 中华神经医学杂志

Objective To explore the clinical application value of high-resolution magnetic resonance imaging (HR-MRI) in the differential diagnoses of moyamoya disease (MMD) and vasculitis-related moyamoya syndrome (V-MMS). Methods A prospective study of clinical data of 22 patients with MMD and 24 patients with V-MMS, admitted to our hospital from January 2014 to September 2016, was performed. HR-MRI and 3D-time of flight-magnetic resonance angiography (3D-TOF-MRA) were performed in all the patients. The proximal middle cerebral artery performance on HR-MRI was recorded: the max-vessel area, min-vessel area, max-lumen area, min-lumen area, wall max-thickness, styles of stenosis of the proximal middle cerebral artery lumen (eccentric stenosis or concentric stenosis), and wall enhancement or not. Results The max-vessel area, min-vessel area, and wall max-thickness of the V-MMS group were significantly larger than those in the MMD group (P<0.05). As compared with patients from MMD group, those from V-MMS group displayed higher distinct and concentric enhancement in the proximal portion of middle cerebral artery (M1 portion) and perforator vessels in basal ganglia region and small vessels in meninges or groove, with statistically significant differences (P<0.05). The sensitivity, specificity and accuracy of M1 portion wall distinct enhancement in diagnosing V-MMS were 75.0％ (18/24), 86.4％ (19/22), and 80.4％ (37/46). The sensitivity, specificity and accuracy of M1 portion wall distinct enhancement combined with perforator vessels in basal ganglia region or small vessels in meningeal or groove in diagnosing V-MMS were 63.6％(15/24), 90.9％(20/22), and 76.1％(35/46). The sensitivity, specificity and accuracy of M1 portion wall distinct enhancement combined with perforator vessels in basal ganglia region or small vessels in meningeal or groove in diagnosing V-MMS were 63.6％ (15/24), 90.9％ (20/22), and 76.1％ (35/46). Conclusion HR-MRI is a good tool in the differential diagnoses of MMD and V-MMS.