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Research progress on the correlation between intracranial arterial remodeling and white matter hyperintensities
WANG Xi  CHEN Peng 

Cite this article as WANG X, CHEN P. Research progress on the correlation between intracranial arterial remodeling and white matter hyperintensities[J]. Chin J Magn Reson Imaging, 2026, 17(8): 147-153. DOI:10.12015/issn.1674-8034.2026.08.016.


[Abstract] White matter hyperintensities (WMH) serve as the core imaging marker of cerebral small vessel disease and are strongly associated with cognitive decline and dementia. Brain arterial remodeling (BAR) refers to pathological structural alterations of large intracranial arteries. Previous studies have mostly focused on focal remodeling at plaque sites, which fails to reflect overall cerebrovascular lesions across the whole brain. The BAR score enables quantitative measurement of diffuse cerebral arterial remodeling and delivers a standardized assessment protocol. Widespread intracranial arterial dilative remodeling is independently correlated with severe WMH. Combined imaging biomarkers of the two conditions can be applied to stratify cognitive risk screening among general elderly populations, high-risk hypertensive groups and patients with mild cognitive impairment, thereby optimizing the risk stratification system for cerebral small vessel disease. Current research in this field lacks in vivo molecular evidence from human subjects, and multicenter cohort studies as well as combined quantitative investigations of vascular walls and microcirculation remain insufficient. Integrated vascular assessments based on AI radiomics and four-dimensional flow imaging in the future can supply imaging evidence for the early prevention and treatment of vascular cognitive impairment. This paper sorts out shared risk factors of BAR and WMH, distinguishes two independent regulatory pathways including blood flow shear stress and vascular inflammation, and illustrates the pathological cycle in which arterial remodeling and WMH exacerbate each other. It also integrates the diagnostic value of multimodal imaging, identifies discrepancies in conclusions of existing studies, and indicates that inconsistent assessment tools, varying study populations and differences in confounding factor adjustment constitute the primary causes of divergent results, offering references for clinical diagnosis and treatment.
[Keywords] cerebral small vessel disease；white matter hyperintensity；intracranial arterial remodeling；cognitive impairment；dementia；magnetic resonance imaging

WANG Xi1   CHEN Peng2*  

1 Department of Radiology, Guilin People's Hospital, Guilin 541002, China

2 Department of Radiology, Affiliated International Zhuang Medicine Hospital of Guangxi University of Chinese Medicine, Nanning 530001, China

Corresponding author: CHEN P, E-mail: 319677005@qq.com

Conflicts of interest   None.

Received  2026-03-10
Accepted  2026-07-18
DOI: 10.12015/issn.1674-8034.2026.08.016
Cite this article as WANG X, CHEN P. Research progress on the correlation between intracranial arterial remodeling and white matter hyperintensities[J]. Chin J Magn Reson Imaging, 2026, 17(8): 147-153. DOI:10.12015/issn.1674-8034.2026.08.016.

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