7T high-resolution TOF-MRA has the ability to image perforating arteries of middle cerebral artery (MCA). The distribution patterns of orifices in CADASIL (cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy) and ICAD (intracranial atherosclerosis disease) patients are still unclear. In this study, for the first time, we investigated the orientation distribution of perforating artery orifices on MCA trunks using 7T TOF-MRA. Specific features are found in the distribution patterns of orifices in patients with CADASIL, ICAD and healthy volunteers. This technique is promising in the pathological studies of intracranial vascular diseases.