Abstract: Objective To explore the clinical value of imaging quantitative indicators as microstructural damage and blood flow perfusion in white matter hyperintensities (WMH) for overactive bladder symptom (OAB) in the elderly patients with cerebral small vessel disease (CSVD). Methods A total of 104 patients with CSVD presenting with WMH in Tangshan Workers’ Hospital were enrolled in this study. According to the symptom score of overactive bladder syndrome (OABSS), the patients were divided into OAB group (n=74) and non-OAB group(n=30). Magnetic resonance diffusion tensor imaging (DTI) and three-dimensional arterial spin labeling (3D-ASL) techniques were used to obtain fractional anisotropy (FA) and cerebral blood flow (CBF) of periventricular white matter hyperintensities (PVWMH) and deep white matter hyperintensities (DWMH), and general information of the patients was collected. The clinical data were compared between OAS group and non-OAS group; Spearman analysis was used to analyze the correlation between the indexes, and receiver operating characteristic (ROC) curve analysis was used to investigate the predictive value of WMH indicators for OAB. Results There were significant differences in age, proportion of diabetes, body mass index (BMI), PVWMH-FA, DWMH-FA and Fazekas scores between the two groups (P<0.05); Spearman correlation analysis showed PVWMH-FA was significantly correlated with OABSS (r=-0.538, P<0.001);The area under ROC curve of PVWMH-FA in predicting OAB was 0.806. Conclusions The PVWMH-FA, a quantitative indicator of microstructural damage in PVWMH of elderly patients with CSVD shows potential clinical value for early diagnosis and disease assessment of OAB.

Key words: white matter hyperintensity, diffusion tensor imaging, arterial spin labeling, overactive bladder symptom, aged