ObjectiveTo explore the role of extracellular fluid, assessed by diffusion tensor imaging (DTI) metrics of free water (FW), in the white matter of patients with cerebral small vessel disease (CSVD).Materials and methodsThe baseline clinical and imaging data of 129 patients with CSVD were collected and reviewed. CSVD MR markers, including periventricular white matter hyperintensity (PWMH), deep white matter hyperintensity (DWMH), cerebral microbleed (CMB), enlarged perivascular space (PVS), and lacunar infarction (LI), were identified, and CSVD burden was calculated. According to total CSVD MR marker score, cases were classified as mild, moderate, or severe. The mean FW and fractional anisotropy (FA) values were calculated using DTI images.ResultsThe mean white matter FW was associated with the CSVD MR markers, including PWMH, DWMH, LI and PVS (P < 0.05). Moreover, age, hypertension, diabetes mellitus, and FW value were associated with total CSVD MR marker score (P < 0.05). Ordinal logistic regression analysis revealed that FW and age were independently associated with CSVD burden (P < 0.05). Finally, FW in white matter was associated with FA (r = –0.334, P < 0.001).ConclusionExtracellular fluid changes, assessed by DTI metrics of FW in white matter, were associated with CSVD markers and burden. An increased extracellular fluid volume in the white matter was associated with lower FA.

Background To explore the correlation between the deep medullary vein (DMV) score and the burden of white matter hyperintensities (WMHs). Methods The baseline clinical and imaging data of 130 patients were analyzed prospectively. DMVs were divided into 6 anatomic regions on susceptibility weighted imaging (SWI) images, with each region scored 0 to 3 based on the visual condition of the vessels, and the DMV score was obtained by adding the scores of the 6 regions. The WHM burden was calculated with the WMH volumes and Fazekas scores for periventricular white matter hyperintensities (PWMHs) and deep white matter hyperintensities (DWMHs) on FLAIR images. Results The WMH volumes and PWMH and DWMH Fazekas scores were correlated with age ,the DMVscore,and blood pressure (P < 0.05), while not correlated with gender, diabetes, hyperlipidemia or smoking (P > 0.05). After multivariate analysis, the DMV score was independently associated with the WMH volume and the PWMH and DWMH Fazekas scores (P < 0.05). Conclusion The DMV score is correlated with the WMHs burden.