ADD-ONS / SCALES
FAZEKAS scale
Created 25/11/2021, last revision 21/04/2023
- proposed by Fazekas in 1987 (Fazekas, 1987)
- a scoring system used for simple assessing of white matter lesions (WML) in the brain on MRI scans
- WMLs often result from arteriolosclerosis (arteriolopathy)
- WMLs often result from arteriolosclerosis (arteriolopathy)
- the scale distinguishes two regions of white matter:
- periventricular white matter (PVWM)
- deep white matter (DWM)
- each region is assessed in terms of the number, size, and confluence of lesions
- it is best assessed on transverse FLAIR or T2-weighted MRI
- in routine practice, the scale is often replaced by the terms mild, moderate, and severe to describe the severity of lesions
- periventricular white matter lesions (PVWM) are not always of an ischemic origin (demyelination, subependymal gliosis, ependymitis, etc.)
- 0 = no lesion
- 1 = “caps” or pencil-thin lining
- 2 = smooth “halo”
- 3 = irregular periventricular signal extending into the deep white matter
- 0 = no lesion
- therefore, only deep white matter (DWM) is assessed when monitoring vascular changes, i.e., FAZEKAS 0-3
- 0 = no lesion
- 1 = punctate lesions
- 2 = beginning confluence
- 3 = extensive confluent areas
