Fluid-Attenuated Inversion Recovery Vascular Hyperintensity in Cerebrovascular Disease: A Review for Radiologists and Clinicians
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Updated: Oct 8, 2025

Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Lichuan Zeng1, Jinxin Chen2, Huaqiang Liao1
1Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Abstract:
Neuroradiological methods play important roles in neurology, especially in cerebrovascular diseases. Fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) is frequently encountered in patients with acute ischemic stroke and significant intracranial arterial stenosis or occlusion. The mechanisms underlying this phenomenon and the clinical implications of FVH have been a matter of debate. FVH is associated with large-vessel occlusion or severe stenosis, as well as impaired hemodynamics. Possible explanations suggested for its appearance include stationary blood and slow antegrade or retrograde filling of the leptomeningeal collateral circulation. However, the prognostic value of the presence of FVH has been controversial. FVH can also be observed in patients with transient ischemic attack (TIA), which may have different pathomechanisms. Its presence can help clinicians to identify patients who have a higher risk of stroke after TIA. In this review article, we aim to describe the mechanism and influencing factors of FVH, as well as its clinical significance in patients with cerebrovascular disease.
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