Clinical Information:



Standard T1, T2, T2 me2d, Diffusion/ADC and Flair Fat Sat axial images were acquired on a 1.5T scanner. T2 coronal and sagittal scans were performed. T1 mpRage sagittal images were acquired. GRE images were performed. T1 mpRage imaging was performed.





  • Extra-axial spaces:  normal
  • Ventricular system:  normal for age
  • Basal Cisterns:  normal
  • Cerebral parenchyma:  normal
  • Midline Shift:  none
  • Cerebellum:  normal
  • Midbrain:  normal
  • Brainstem:  normal
  • Vascular system:  normal
  • Global cortical atrophy score: 0 – no cortical atrophy
  • Mesial Temporal Atrophy: 0 – no atrophy
  • Koedam score for parietal atrophy: 0 – no atrophy
  • Fazekas score of WM lesions: 0 – no or a single white matter lesion
  • Strategic lesions: none


  • Calvarium:  normal
  • Visualised paranasal sinuses:  normal
  • Visualised orbits:  normal
  • Visualised upper C-spine:  normal
  • Sella and skull base:  normal


Normal study. No evidence of abnormal atrophy to suggest dementia.

Explanatory Information

GCA-scale for Global Cortical Atrophy

GCA scale is the mean score for cortical atrophy throughout the complete cerebrum:

  • 0: no cortical atrophy
  • 1: mild atrophy: opening of sulci
  • 2: moderate atrophy: volume loss of gyri
  • 3: severe (end-stage) atrophy: ‘knife blade’ atrophy.

MTA-scale for Medial Temporal lobe Atrophy

  • score 0: no atrophy
  • score 1: only widening of choroid fissure
  • score 2: also widening of temporal horn of lateral ventricle
  • score 3: moderate loss of hippocampal volume (decrease in height)
  • score 4: severe volume loss of hippocampus

< 75 years: score 2 or more is abnormal.
> 75 years: score 3 or more is abnormal.

Fazekas scale for WM lesions

  • Fazekas 0: None or a single punctate WMH lesion
  • Fazekas 1: Multiple punctate lesions
  • Fazekas 2: Beginning confluency of lesions (bridging)
  • Fazekas 3: Large confluent lesions

Koedam score for Parietal atrophy

  • Grade 0 – no parietal cortical atrophy
  • Grade 1 – mild parietal cortical atrophy
  • Grade 2 – substantial parietal cortical atrophy
  • Grade 3 – end-stage ‘Knife-blade’ atrophy

Frederik Barkhof, Fox, N.C., Bastos-Leite, A.J. and Scheltens, P. (2011). Neuroimaging in Dementia. Berlin, Heidelberg: Springer Berlin Heidelberg.

‌For more information, please see the excellent website Radiology Assistant, Dementia: role of MRI