Background : Cerebral angiography has been the gold standard for the assessment of intracranial collateral circulation currently; however it has not been widely applied due to the disadvantages such as invasiveness and high costs.We aimed to evaluate the value of fast fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) in assessing infarct morphology in patients with symptomatic internal carotid artery (ICA) or middle cerebral artery (MCA)occlusions.Methods: Magnetic resonance (MR) diffusion-weighted imaging (DWI) and FLAIR sequences, and carotid/cerebral magnetic resonance angiography (MRA) were obtained from 102consecutive prospective study patients with symptomatic ICA or MCA occlusions.The location and score of FVH were evaluated according to Olindos method, and the patients were diagnosed as Low FVHs and High FVHs based on FVH score, and Distal FVH and Proximal FVHbased on FVH location.The differences between infarct morphologies were analyzed in these patients.Results: FVH were detectable in 62 (60.8%) patients were diagnosed as High FVHs and40 (39.2%) patients were Low FVHs based onOlindos scale ≥ 4 or < 4.There were no statistically significant differences in age, gender, hypertension, diabetes, hyperlipidemia, smoking history and vascular occlusive site between High and Low FVHs patients (P> 0.05) except for infarct morphology (P<0.01).Patients with Distal FVH presented with significant (P< 0.01) perforating artery infarct and border zone infarct, whereas those Proximal FVH had significant (P<0.01) large territorial infarcts.Conclusion: The scores and locations of FVH might be a predictive imaging marker for infarct morphology in symptomatic ICA or MCA occlusion.