The ARWMC Rating Scale

Created 25/11/2021, last revision 19/01/2023

ARWMC (Age Related White Matter Changes)

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 the involvement of U fibers
Basal ganglia lesions
0 no lesion
1 1 focal lesion  (≥ 5 mm)
2 > 1 focal lesion
3 confluent lesions
ARWMC scale - white matter lesions
ARWMC scale - basal ganglia lesions
  • white matter lesions (WMLs) on MRI are defined as bright (hyperintense) lesions ≥ 5 mm on T2, PD, or FLAIR images
  • WMLs on NCCT are defined as hypodense areas ≥ 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)
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The ARWMC Rating Scale