No-reference image quality assessment (NR-IQA) aims to simulate the process of perceiving image quality aligned with subjective human perception. However, existing NR-IQA methods either focus on global representations that leads to limited insights into the semantically salient regions or employ a uniform weighting for region features that weakens the sensitivity to local quality variations. In this paper, we propose a fine-grained image quality assessment model, named RSFIQA, which integrates region-level distortion information to perceive multi-dimensional quality discrepancies. To enhance regional quality awareness, we first utilize the Segment Anything Model (SAM) to dynamically partition the input image into non-overlapping semantic regions. For each region, we teach a powerful Multi-modal Large Language Model (MLLM) to extract descriptive content and perceive multi-dimensional distortions, enabling a comprehensive understanding of both local semantics and quality degradations. To effectively leverage this information, we introduce Region-Aware Semantic Attention (RSA) mechanism, which generates a global attention map by aggregating fine-grained representations from local regions. In addition, RSFIQA is backbone-agnostic and can be seamlessly integrated into various deep neural network architectures. Extensive experiments demonstrate the robustness and effectiveness of the proposed method, which achieves competitive quality prediction performance across multiple benchmark datasets.