RadEssentialReading-room reference
Fazekas scale
Visual grading of T2/FLAIR white matter hyperintensities, scored separately for periventricular and deep white matter. Most reports quote the deep white matter grade.
| Grade | Periventricular (PVH) | Deep white matter (DWMH) |
|---|---|---|
| 0 | Absent | Absent |
| 1 | Caps or pencil-thin lining | Punctate foci |
| 2 | Smooth halo | Beginning confluence of foci |
| 3 | Irregular, extending into deep white matter | Large confluent areas |
Pearls
- Deep grade 1 can be normal with age; grade 2–3 is generally abnormal at any age and supports small vessel disease in the right context.
- Grade the dominant pattern; do not count lacunes or perivascular spaces as WMH.
Sources
- Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol. 1987;149:351–356.PubMed ↗
Radessential summarizes published classification systems for practicing radiologists. Summaries are condensed; confirm details against the cited source before relying on them for patient care.