Abstract: Intracranial atherosclerotic disease (ICAD) of a major intracranial artery, including middle cerebral artery (MCA),
basilar artery, is the most common causes of stroke and is associated with a high risk of recurrent stroke in China. The
difficulty to treatment these high-risk disease is to identify high-risk stroke subgroups and to develop more effective treatments
(aggressive medical therapy/endovascular therapy). With the benefits, including non-invasive, in vivo, and no-ionizing
radiation, 3.0 Tesla high-resolution magnetic resonance imaging (HR MRI) could be used to stratify high-risk patients, monitor
progression of disease, and evaluate clinical efficacy, based on MCA wall structure and plaque characteristic. HR MRI has the
latency of predicting high-risk patients benefit from endovascular therapy, having a broad application prospect during
psot-SAMMPRIS era. The current research on MCA stenosis using HR MRI focuses on methodology, diagnosis and differential
diagnosis, etiology, and lacks of clinical efficiency evaluation and prognostic analysis of ICAD treatment, especially lacks the
research on in-stent restenosis, which needs further investigation.