Objective Prediction of symptomatic atherosclerotic intracranial arterial stenosis (sICAS) were treated with the efficacy of stent implantation image sensitive index, in order to provide the basis for the determination of such patients, early treatment and treatment scheme. Methods 120 cases of severe sICAS in our hospital were randomly divided into the control group and the observation group, 60 cases in each group. Before treatment, all patients were treated with perfect MRI examination (conventional MRI+MRA, PWI, high resolution magnetic resonance imaging). The control group was given routine Department of internal medicine treatment, and the observation group was treated with endovascular stent assisted angioplasty. All patients were followed up for 1 years. Compared with before treatment and were followed up for 12 months of complications in two groups of patients with occurrence rate, stroke recurrence rate, mean through time (MTT), brain blood volume (CBV) and cerebral blood flow (CBF) and image analysis correlation of each index and treatment options. Results Compared with before treatment, two groups of MTT decreased significantly, CBV and CBF increased significantly compared with statistical significance (P<0.05), compared with the control group, observation group of MTT decreased significantly, CBV and CBF increased significantly, stroke recurrence rate was significantly lower compared with statistical significance (P<0.05). Conclusion Endovascular stent implantation can reduce the recurrence rate of stroke, and multi modality MRI perfusion imaging can be used to evaluate the degree of stenosis of symptomatic atherosclerotic intracranial arteries.