ADD-ONS / SCALES
The ARWMC Rating Scale
David Goldemund M.D.
Updated on 26/11/2023, published on 25/11/2021
ARWMC (Age-Related White Matter Changes)
- this scale was designed to evaluate white matter changes (WMCs) on either CT or MRI scans
- sensitivity and reliability are higher with MRI
- differences between MRI and CT in the detection of WMCs are primarily related to lesion size – MRI is better at detecting small lesions, while medium and large lesions are equally well visualized by both modalities
- regional differences play a minor role, as ARWMC lesions occur in areas that can usually be imaged with high quality by both MRI and CT
- WMCs definition:
- T2 or FLAIR MRI images – bright (hyperintense) lesions ≥ 5 mm
- NCCT – hypodense areas ≥ 5 mm
- T2 or FLAIR MRI images – bright (hyperintense) lesions ≥ 5 mm
- the following areas are scored (each hemisphere separately):
- frontal
- parieto-occipital
- temporal
- infratentorial, including the cerebellum
- basal ganglia (striatum, globus pallidus, thalamus, internal and external capsule, and insula)
- FAZEKAS scale is easier to use in routine clinical practice
White matter lesions (WML)
|
|
0 | no lesion (including symmetrical, well-defined caps or bands) |
1 | focal lesions |
2 | an incipient confluence of lesions |
3 | diffuse involvement of the entire region, with or without U-fibers involvement |
Basal ganglia lesions | |
0 | no lesion |
1 | 1 focal lesion (≥ 5 mm) |
2 | > 1 focal lesion |
3 | confluent lesions |