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To review the diagnosis and treatment of a case of hypercalcium crisis caused by primary hyperparathyroidism（PHPT） and prophylactic treatment of hungry bone syndrome. In a 32-year-old male with hypercalcemia, the main manifestations were loss of appetite, nausea, polyuria, polydipsia, fatigue, lethargy, etc. parathyroid hormone, serum calcium increased, thyroid function was normal, thyroid color ultrasound and MRI showed space-occupying behind the right thyroid, radionuclide examination showed abnormal imaging agent concentration in the right parathyroid area, there was a history of pathological fracture. Clinically diagnosed as hypercalcemia crisis secondary to PHPT.
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Male , Humans , Adult , Hypercalcemia/diagnosis , Hyperparathyroidism, Primary/surgery , Parathyroid Hormone , Hypocalcemia/complications , Thyroid Gland , CalciumABSTRACT
Objective:To explore the application value of heuristic teaching combined with anchored instruction in nursing teaching in emergency department.Methods:A total of 80 nursing students assigned to the Emergency Department of The First Affiliated Hospital of Air Force Medical University from July 2019 to October 2020 were divided into control group and research group, with 40 cases in each group. The control group used traditional teaching, and the research group used heuristic teaching combined with anchored instruction. At the end of the practice, the teaching effect was evaluated through the examination results (theoretical examination and scenario simulation practice skills examination) and questionnaire survey of teaching quality and teaching satisfaction. SPSS 22.0 was used for t test and chi-square test. Results:The theoretical examination scores [(93.20±2.88) vs. (90.53±3.06)] and the practical skill examination scores (basic operation examination, specialized operation examination and comprehensive quality) of the study group were higher than those of the control group, and the difference was statistically significant ( P<0.05). The overall situation of teaching quality and teaching satisfaction of nursing students in the study group was significantly higher than that in the control group, and the difference was statistically significant ( P<0.05). Conclusion:Heuristic teaching combined with anchored instruction is helpful to improve the theoretical knowledge, practical skills, operation level and comprehensive quality of nursing students, and has good popularization value in clinical nursing teaching.
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Objective:To investigate the effect of the number of retrieval attempts on the outcomes after successful recanalization of mechanical thrombectomy in patients with acute ischemic stroke.Methods:Patients with acute large vessel occlusive ischemic stroke underwent mechanical thrombectomy and successful postoperative recanalization in the Stroke Center of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2019 to May 2020 were retrospectively enrolled. According to the number of retrieval attempts during the procedure, the patients were divided into <3-attempt group and ≥3-attempt group. The demographic data, procedure-related indexes, periprocedural complications and outcomes at 90 d after the procedure were compared between the two groups.Results:A total of 106 patients, aged 69.8±1.3 years, were enrolled, and 55 were males (51.9%). Eight-three patients (78.3%) were in the <3-attempt group, and 23 (21.7%) were in the ≥3-attempt group. Forty-one patients (38.7%) had good outcomes (the modified Rankin Scale score ≤2) at 90 d, and 11 (10.4%) died. There were no significant differences in the incidence of intracranial hemorrhage (30.4% vs. 20.5%; χ2=1.019, P=0.313), the good outcome rate at 90 d (34.8% vs. 39.8%; χ2=0.188, P=0.665) and mortality (8.7% vs. 10.8%; P=0.999) between the ≥3-attempt group and <3-attempt group, but the incidence of symptomatic intracranial hemorrhage was significantly higher than that in the <3-attampt group (13.0% vs. 1.2%; P=0.031). Multivariate logistic regression analysis showed that the number of retrieval attempts was not significantly associated with poor outcome. Conclusion:The more retrieval attempts may be related to symptomatic intracranial hemorrhage, but it does not affect the clinical outcomes of patients with successful recanalization at 3 months.
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Objective:To investigate the dynamic change characteristics of peripheral blood interferon-γ (INF-γ), interleukin (IL)-4 levels and T helper cell (Th)1/Th2 balance in acute, subacute and restoration stages of children with Kawasaki disease (KD).Methods:Forty-one children with KD received treatment in Women′s and Children′s Hospital Affiliated of School of Medicine University of Electronic Science and Technology of China, Chengdu Women′s and Children′s Central Hospital from May 2017 to January 2020 were enrolled as the observation group, and 41 healthy children examinee from the same period were enrolled as the control group. Children with KD of the observation group were performed with tuberculin pure protein derivative (PPD) test when acute and restoration stage of KD respectively. Peripheral venous blood were drawn from KD children of the observation group in acute, subacute and restoration stage and the control group respectively, serum immune globulin IgG, IgA, IgM and IgE, serum IFN-γ and IL-4 levels were detected by enzyme linked immunosorbent assay (ELISA).Results:Positive rates of PPD test in the restoration stage was higher than that in the acute stage: 65.85%(27/41) vs.17.07%(7/41), there was statistical difference ( χ2 = 20.10, P<0.05). The levels of serum IgG, IgA, IgM and IgE in the acute stage , subacute stage and restoration stagewere gradually decreased ( P<0.05). The levels of serum IgG, IgA, IgM and IgE in the restoration stage and the control group had no significant differences ( P>0.05). The levels of serum IFN-γ and IFN-γ/IL-4 in the acute stage , subacute stage and restoration stage were gradually increased ( P<0.05), the level of IL-4 was gradually decreased ( P<0.05), but the levels of serum IFN-γ, IL-4 and IFN-γ/IL-4 in the restoration stage and the control group had no significant differences ( P>0.05). Conclusions:Among the children with KD in acute stage, serum level of IFN-γ is decreased while serum IL-4 level is increased, and Th1/Th2 balance shifts to Th2. Along with the stabilization of disease, the levels of serum IFN-γ and IL-4 are normalized, and Th1/Th2 balance presents a recovering trend and they almost recover to normal after entering the restoration stage.
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Objective:To investigate the efficacy and safety of intravenous tirofiban after endovascular therapy in patients with acute intracranial large atherosclerotic stroke.Methods:Patients with acute intracranial large atherosclerotic stroke received endovascular therapy in the Stroke Center, Nanjing Drum Tower Hospital from January 2018 to December 2020 were enrolled. The incidence of symptomatic intracranial hemorrhage in patients of tirofiban group and non-tirofiban group during perioperative period and the outcome after procedure at 90 d were analyzed.Results:A total of 172 patients were included. Their average age was 66.0 years and 126 patients were male (73.3%). Ninety-two patients (53.5%) used tirofiban, and 120 (69.8%) had good outcomes. Compared with the non-tirofiban group, the tirofiban group had a significantly higher rate of good outcome at 90 d after procedure (77.2% vs. 61.3%; P=0.023). The reocclusion rate was significantly lower (7.6% vs. 18.8%; P=0.039), while there was no statistically significant difference in the incidence of symptomatic intracranial hemorrhage during periprocedureal period (4.3% vs. 3.8%; P=0.990). There was a significant independent correlation between the use of tirofiban intravenously and the good outcome at 90 d after procedure, both in the overall patients (odds ratio 0.208, 95% confidence interval 0.064-0.680; P=0.009) and the patients with severe stroke (odds ratio 0.181, 95% confidence interval 0.050-0.658; P=0.009) were all the same. Conclusion:For patients with acute intracranial large atherosclerotic stroke who received intravascular therapy, intravenous tirofiban can significantly improve the clinical outcome at 90 d after procedure, and will not increase the risk of symptomatic intracranial hemorrhage.
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Objective:To investigate the application of side branch protection technique in interventional treatment of intracranial arteriosclerosis stenosis.Methods:We reviewed the patients who underwent interventional treatment of intracranial arteriosclerosis stenosis from November 2018 to May 2021 in Affiliated Drum Tower Hospital of Nanjing University Medical School, and analyzed the role of side branch protection technique in the prevention and treatment of complications. Relevant evaluation indicators including: (1) imaging: patency of blood flow in target vessels and branch vessels; (2) clinical presentation: ischemic stroke or transient ischemic attack (TIA) events within 72 hours and one month follow-up results.Results:A total of 9 patients underwent side branch protection during interventional treatment for intracranial arteriosclerosis stenosis, the blood flow of target vessels was improved obviously after operation, and the blood flow of the affected branches was not affected; no stroke or TIA events occurred in 72 hours after operation and one month follow up.Conclusions:Proper application of side branch protection technique can reduce the perioperative complications effectively during the interventional treatment for intracranial arteriosclerosis stenosis.
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ObjectiveTo predict the underlying mechanism of Bushen Huoxuetang in treating osteoporosis related to endocrine therapy in breast cancer by network pharmacology and to verify the results through in vitro cell model. MethodThe main effective components and targets of Bushen Huoxuetang were screened out through network pharmacology， and the targets of osteoporosis related to endocrine therapy in breast cancer were further obtained. The intersected targets were analyzed by Gene Ontology （GO） functional annotation and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment. Kaplan Meier plotter was used to analyze the survival of crucial targets. Finally， the inhibitory activity against cell proliferation was evaluated by in vitro methye thiazolye telrazlium（MTT） assay. The key targets and pathways were verified by Western blot， and the mRNA expression of the key targets was evaluated by real-time polymerase chain reaction（Real-time PCR）. ResultA total of 716 active components and 249 key targets of Bushen Huoxuetang were obtained from network pharmacology. There were 135 common targets， among which protein kinase B（Akt）1 and hypoxia-inducible factor-1α （HIF-1α） were two key targets. Additionally， 531 biological processes， 62 cellular components， 162 molecular functions， and 145 signaling pathways including breast cancer and endocrine resistance were involved. The key targets were effectively enriched in phosphatidylinositol 3-kinases（PI3K）/Akt and HIF-1 signaling pathways. According to the MTT assay， the cell proliferation rate and cell motility of MCF-7 and T47D cells in the luminal A cell line were reduced by Bushen Huoxuetang treatment （22.5， 45， 90 g·L-1， and 45， 90， 180 g·L-1） for 48 h as compared with the blank group. As revealed by Western blot， MCF-7 cells were treated with Bushen Huoxuetang （0， 15， 60 g·L-1） for 48 h， and the relative expression of p-PI3K， PI3K， p-Akt， Akt， and HIF-1α was decreased in a dose-dependent manner as compared with the blank group （P<0.05， P<0.01）. Real-time PCR was used to detect the mRNA expression of the key target HIF-1α. The results showed that the mRNA expression of HIF-1α in MCF-7 cells was decreased with the increase in the dose （P<0.01）， and the change was in a concentration-dependent manner. ConclusionThe mechanism of Bushen Huoxuetang in the treatment of osteoporosis related to endocrine therapy in breast cancer may be related to the key targets including Akt1 and HIF-1α through the PI3K/Akt/HIF-1α signaling pathway.
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Objective:To investigate the clinical and imaging characteristics of deep cerebral vein thrombosis (DCVT).Methods:From December 2006 to December 2019, patients with DCVT admitted to Nanjing Drum Tower Hospital were enrolled retrospectively. The clinical manifestations, imaging examinations, treatment and prognosis of the patients were analyzed.Results:A total of 11 patients with DCVT were enrolled in the study, including 4 females and 7 males. Their average age of onset was 41.6 years. Their most common clinical manifestations were acute or subacute onset headache (11/11, 100%), disturbance of consciousness (5/11, 45.5%), and seizures (4/11, 36.4%). All 11 patients involved straight sinus, 9 involved the great cerebral vein, 5 involved the internal cerebral vein, and 1 involved the basilar vein. All patients were complicated with other venous sinus thrombosis, and 3 were complicated with superficial cortical venous thrombosis. Early CT plain scan (within 1 week of onset) of 8 patients (72.3%) showed high-density point sign of great cerebral vein or cord sign of straight sinus. Head MRI showed that 90.9% (10/11) of patients had brain parenchymal damage, thalamic involvement (5/11, 45.5%) was the most common, followed by deep white matter (4/11, 36.4%). One patient received urokinase interventional thrombolysis and died on the 6 th day of onset. The remaining 10 patients improved after receiving anticoagulant therapy. Follow up of 4 months to 13 years showed that 4 patients left with mild to moderate disability (the modified Rankin scale score 1-3), and 6 returned to normal. Conclusions:Headache, disturbance of consciousness and seizures are common clinical manifestations of DCVT. Imaging examination shows that the possibility of DCVT should be warned when the thalamus or deep white matter is involved. It is necessary to pay attention to the high-density thrombus spot sign and cord sign on early CT plain scan. DCVT patients with cortical venous thrombosis progressed rapidly in the acute phase, and the outcomes were poor.
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In recent years, the incidence of stroke in young adults, especially ischemic stroke, has been increasing worldwide. Due to its high disability, high mortality, and high recurrence, it has brought a serious burden to society and families. The common causes of ischemic stroke in young adults include large artery atherosclerosis and small vessel occlusion, while the rare causes such as patent foramen ovale, hereditary cerebral small vessel disease, cerebral artery dissection, moyamoya disease, vasculitis, and cryptogenic stroke also account for a high proportion. Its pathogenesis is complex, and diagnosis and treatment are difficult. This article reviews the latest research progress of the pathogenesis of ischemic stroke in young adults.
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Objective:To investigate the clinical and imaging characteristics of isolated cortical vein thrombosis (ICVT) in order to improve the understanding of this rare disease.Methods:From December 2013 to September 2019, patients with ICVT admitted to Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were collected retrospectively. Their clinical manifestations, imaging examination, treatment and prognosis were analyzed.Results:A total of 6 patients with ICVT were enrolled in the study, including 3 males and 3 females, with an average age of 37 years. The main clinical manifestations were acute seizures (5/6, 83.3%), focal neurological deficits (3/6, 50.0%), and headache (3/6, 50.0%). In the imaging examination, the direct signs of ICVT were spot sign and cord sign, and the indirect signs were cerebral lobe hemorrhage, infarction, or edema.Conclusions:Seizures, focal neurological deficits and headaches are common manifestations of ICVT. Multimodality imaging examinations are helpful for early diagnosis of the disease.
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The 19th China Cerebrovascular Disease Congress, sponsored by the Chinese Medical Association and the Chinese Society of Neurology, was held in Nanjing from April 11 to 13, 2019. At this meeting, experts in clinical and basic research on cerebrovascular diseases at home and abroad were invited and the latest research progress, clinical research and diagnosis and treatment guidelines at home and abroad were introduced. What is particularly wonderful is the case discussion of difficult cerebrovascular disease.
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The 19th China Cerebrovascular Disease Congress,sponsored by the Chinese Medical Association and the Chinese Society of Neurology,was held in Nanjing from April 11 to 13,2019.At this meeting,experts in clinical and basic research on cerebrovascular diseases at home and abroad were invited and the latest research progress,clinical research and diagnosis and treatment guidelines at home and abroad were introduced.What is particularly wonderful is the case discussion of difficult cerebrovascular disease.
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Objective:To investigate whether the basal blood glucose level before cerebral infarction has an impact on acute stress hyperglycemia.Methods:A total of 366 patients with cerebral infarction admitted into the neurology department of our hospital from February 2008 to May 2012 were enrolled in this study. Acute stress hyperglycemia was reflected by stress-induced glucose up-regulation ratio (SIGUR), and the basal glucose before cerebral infarction was reflected by glycosylated hemoglobin A1c (HbA1c). The correlation between SIGUR and HbA1c was analyzed in the different populations. The difference in SIGUR was compared among the non-diabetic group, diabetes with poor blood glucose control group (HbA1≥6.5%) and diabetes with well blood glucose control group (HbA1c<6.5%). The relationship between high level of SIGUR (Q4) and HbA1c was performed through logistic regression analysis.Results:SIGUR was correlated with HbA1c, no matter in the non-diabetic, diabetic or total populations ( r=-0.200, 0.195 and 0.324, P=0.010, 0.011 and 0.000). The level of SIGUR was higher in diabetes with poor blood glucose control group than in the non-diabetes and diabetes with well blood glucose control group ( F=25.842, P=0.000), but there was no significant difference between the non-diabetic group and diabetes with well blood glucose control group ( P>0.05). Logistic regression analysis showed that the high level of SIGUR was correlated to HbA1c in the total populations ( OR=1.460, P=0.000). In the diabetic group, the probability of higher SIGUR level was increased along with the increased HbA1c level ( OR=1.237, P=0.021), while the probability of higher SIGUR level was decreased along with the increased HbA1c level in the non-diabetic group ( OR=0.233, P=0.010). Conclusions:Acute stress hyperglycemia is correlated to the basal blood glucose before cerebral infarction, and blood glucose increases more prominently in those patients with high basal blood glucose level, especially in the diabetic patients.
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Simulation-based medical education can ensure medical safety, reduce medical errors and improve students' clinical skills. At present, the main problems in medical teaching are the conflict between doctors and patients, the contradiction between medical teaching and ethics, the shortage of teaching resources and the lack of a universal assessment standard. The advantages of simulation-based medical education are its safety, repeatability, standardization, controllability, relative authenticity, and the cultivation of humanistic spirit and teamwork for students. Simulation-based medical education has two major limits. First, its teaching effect relies on the function and quality of each model. Second, simulation cannot replace clinical practice. This article proposes the following ways and means for promoting the simulation-based medical education: training of faculty is the core, establishment of courses is the focus, cooperation and communication is an important way to promote development, and phased and refined development is the future direction.
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Objective To investigate the relationship between the stress induced glucose up-regulation and brainstem infarction. Methods Three hundred and sixty-six patients of cerebral infarction in the department of neurology were included in this study. Stress induced glucose up-regulation was reflected by stress induced glucose up-regulation ratio (SIGUT), and the level of SIGUT was compared between groups of brainstem and non-brainstem infarction. SIGUT was categorized into 4 groups according to the quartiles, and relative variables were compared among 4 groups. The level-risk relationship between high level of SIGUT and brainstem infarction was performed through logistic regression. Results The level of SIGUT was higher in group of brainstem infarction than that in group of non-brainstem infarction: 1.060 ± 0.272 vs.1.159 ± 0.301(P＝0.020). The percent of male, diabetes, brainstem infarction and level of FBG, HbA1c, NIHSS was obviously different in the 4 groups of SIGUT according to the quartiles (P<0.05). High level of SIGUT was correlated to brainstem infarction in the single-factor or multivariable logistic regression adjusted for relative variable (P < 0.05). Conclusions Stress induced glucose up-regulation is correlated to the brainstem infarction, which is prone to happen in brainstem infarction, and the magnitude is more prominent.
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Objective To investigate the roles of Pipeline embolization device ( PED) in combination with coils in the treatment of large and giant unruptured internal carotid artery aneurysms. Methods From January 2014 to December 2016,51 patients with large (diameter 10-25 mm) and giant (diameter >25 mm) internal carotid artery aneurysms treated at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively. Among them,35 were females and 16 were males, the average age was 53 ±13 years (range 15-71). They were divided into a PED group (n=31) and a PED combined with coil group (n=20) according to whether using coils for packing aneurysm cavity or not. The treatment of two groups of patients and ≥6 months of imaging follow-up effect were analyzed. The embolic rate was evaluated by Raymond grade. Results Thirty-one patients with 32 aneurysms ( mean diameter 15 ± 3 mm) in the PED group were treated with 33 PEDs,including 15 with cavernous sinus aneurysm and 17 with supraclinoid aneurysm;20 patients with 21 aneurysms ( mean diameter 17 ± 4 mm) were treated with 22 PEDs in the PED combined with coil group,including 10 cavernous sinus aneurysms and 11 supraclinoid carotid aneurysms. Six months after procedure,imaging follow-up revealed that the incidence of residual aneurysm ( Raymond grade Ⅱ-Ⅲ) in the PED group was significantly higher that that in the PED combined with coil group (9. 7% [n =3] and 0％,respectively). The incidence of thrombosis in PED combined with coil group was significantly higher than that in the PED group,there was significant difference between two groups (P<0. 05). Conclusions When using PED to treat large and giant internal carotid artery aneurysms,packing aneurysm cavity in combination with coils can reduce the incidence of residual aneurysm,but it may have a higher risk of thrombotic events. A prospective randomized controlled trial of large samples is still needed to prove it.
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Objective To compare the safety and efficacy of directly thrombectomy and bridging therapy in patients with acute large vessel occlusion stroke within 4.5 h of onset.Methods From April 2014 to September 2017, patients with acute large vessel occlusion stroke treated with emergency mechanical thrombectomy in Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School were collected. The patients who were eligible for intravenous thrombolysis and whose onset time was ≤4.5 h were selected. The propensity score matching analysis and McNemar test were used to compare the safety and efficacy of direct mechanical thrombectomy and bridging therapy. Results A total of 41 patients with acute large vessel occlusion stroke were enrolled.The final propensity score matching was 12 pairs.In the direct thrombectomy group, the time from door to femoral artery sheath placement was significantly reduced (P=0.03), but there was no significant difference in the good functional outcome rate, mortality rate, and incidence of symptomatic intracranial hemorrhage between the two groups of patients at 90 d(P>0.05).Conclusion It is safe and effective to start direct mechanical thrombectomy within 4.5 h of onset in patients with acute large vessel occlusion stroke and can significantly shorten the time of vascular recanalization.
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Objective To investigate the safety and effectiveness of digital subtraction angiography (DSA) in the surgical treatment of intracranial arteriovenous malformations (AVMs) in children.Methods Between December 2015 and February 2017,the clinical and imaging data of 9 children with AVM (2-14 years) underwent hybrid surgery at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively.According to the Spetzler-Martin grade,there were 2 patients with grade Ⅰ,3 with grade Ⅱ,2 with grade Ⅲ,and 2 with grade Ⅳ.All the children were treated with microsurgery,and their AVMs were removed by real-time assistance using DSA technique during the operation.The imaging cure rate of surgical treatment and the complications of intraoperative angiography of the children were analyzed.The children were followed up clinically after procedure.According to the modified Rankin scale (mRS) score,their prognoses were evaluated.Results Intraoperative angiography revealed that the AVMs in 8 of 9 children were resected completely,and 1 had a residual lesion,then it was resected completely.Immediately after the resection of the nidi,the angiography confirmed that the nidi of 9 children were resected completely.No related complications caused by intraoperative angiography were observed.Nominal aphasia occurred in 1 child after procedure,and he recovered gradually after 6 months.Pulmonary infection occurred in 2 children,and they were cured after anti-infection treatments.Postoperative follow-up mRS scores were 0-1 in 8 children,2 in 1 child,and no rebleeding was observed.Conclusions In children undergoing AVM surgery,initial observation of DSA is safe and effective.Intraoperative angiography can guide the complete resection of the lesions in real time,improve the surgical cure rate of AVMs,and improve the prognosis of children.
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Objective To investigate the diagnostic and treatment results of arteriovenous fistula of cauda equina.Methods From January 2000 to December 2015,9 Patients with arteriovenous fistula of cauda diagnosed and treated at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively,including 6 males and 3 females.Their ages were 17-58 (mean 39±14) years.The diagnoses were confirmed by digital subtraction angiography (DSA) or surgery (the lesions were located on the cauda equine,which were fed by the arterial supply of the nerve root,and the drainage vein flowed upward into the perimedullary vein).The clinical data,imaging data,and treatment follow-up results of the patients were analyzed.Results The patients presented with weakness of both lower extremities and disturbances of bowel movement and urination.Aminoff Logue score for spinal function was 7.2±3.2 before procedure.The median course of disease was 6.0 (4.5-18.0) months.Angiography showed that the vascular architecture types of the lesions were divided into simple fistula type and micro-nidus type.The feeding arteries were all the nerve root branches of the internal iliac artery.Three patients complicated with conical part of the intramedullary arteriovenous malformations.Eight patients were treated with endovascular embolization,one was treated by operation.No patients were treated with combined interventional surgery,and no surgery-related complications were observed.The mean follow-up duration was 20.1±6.7 months.Imaging follow-up showed that they all reached anatomic cure.Aminoff Logue score dropped to 4.6±2.8 after treatment.There were significant differences before and after treatment in Aminoff Logue score of the patients (t=4.276,P<0.05).Conclusions The nerve root arteriovenous fistula of the cauda equina can be diagnosed by DSA findings.Symptomatic patients are eligible for the indication of endovascular or surgical treatment.Anatomy and functional prognosis are satisfactory after treatment.
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Objective To investigate the roles of high-resolution magnetic resonance imaging (HR-MRI) in the diagnosis and treatment of vertebrobasilar dissecting aneurysms (VBDA).Methods From January 2016 to December 2016,62 patients with VBDA admitted to Xuanwu Hospital,Capital Medical University using 3.0 T HR-MRI (3D-TOF-MRA,3D-T1WI,and 3D-T1WI+C sequence) and diagnosed by DSA were analyzed retrospectively.They were divided into either an asymptomatic group (n=18) or a symptomatic group (n=44) according to their medical histories.Their clinical features,imaging features,and the relationship with prognosis were analyzed.Results HR-MRI revealed that the double lumen sign/intimal flap accounted for 27.8% (n=5) and 54.5% (n=24) respectively in the asymptomatic group and symptomatic group.The intramural hematoma accounted for 22.2% (n=4) and 43.2% (n=19) respectively in both groups.The enhancement of aneurysmal wall accounted for 33.3% (n=6) and 77.3% (n=34) in the asymptomatic group and symptomatic group.There were significant differences in the above features between the two groups (all P<0.05).In the symptomatic group,18.2% (n=8) of patients had aneurysm recurrence,which was significantly higher than the asymptomatic group (5.6%,n=1).The difference between the two groups was statistically significant (P<0.05).Conclusions HR-MRI can better reveal the lesion characteristics of VBDA.The rates of aneurysmal wall enhancement and recurrence in symptomatic VBDAs are higher,which indicates that HR-MRI can assess the stability of the aneurysmal wall and identify the prognosis to a certain extent.