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Intracranial atherosclerotic disease (ICAD) is a leading cause of ischemic stroke, particularly in China and Asia. Traditional diagnostic imaging methods may miss plaques that do not cause significant stenosis. However, high-resolution magnetic resonance imaging (HR-MRI) allows for direct assessment of the intracranial artery wall and has been used to study atherosclerotic plaques. A recent study in China found that ICAD detected using HR-MRI increases the long-term risk of a first-ever ischemic stroke by 2.5 times in a stroke-free population. The study suggests that more aggressive medication and screening high-risk patients using HR-MRI may be beneficial in preventing first-ever strokes. However, there are limitations to the study, including the assessment of only certain intracranial arteries and the use of lower-resolution HR-MRI sequences. [Extracted from the article]