Volumetric White Matter Hyperintensity Ranges Correspond to Fazekas Scores on Brain MRI

•Distinct white matter disease volumes were found to represent Fazekas scores in a predictable way.•Computer-based volumetric analysis of MRI was performed using readily available software for future research methodology.•A modified Fazekas score that includes a score of 4 may be useful in the futur...

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Published in:Journal of stroke and cerebrovascular diseases 2022-04, Vol.31 (4), p.106333-106333, Article 106333
Main Authors: Andere, Ariana, Jindal, Gaurav, Molino, Janine, Collins, Scott, Merck, Derek, Burton, Tina, Stretz, Christoph, Yaghi, Shadi, Sacchetti, Daniel C., Jamal, Sleiman El, Reznik, Michael E., Furie, Karen, Cutting, Shawna
Format: Article
Language:English
Subjects:
3D model
Aging
Brain - diagnostic imaging
Fazekas
Humans
Leukoaraiosis
Magnetic Resonance Imaging - methods
Manual segmentation
MRI
Neuroimaging
White Matter - diagnostic imaging
White matter hyperintensities
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Summary:•Distinct white matter disease volumes were found to represent Fazekas scores in a predictable way.•Computer-based volumetric analysis of MRI was performed using readily available software for future research methodology.•A modified Fazekas score that includes a score of 4 may be useful in the future when discussing outcomes. White matter hyperintensity (WMH) is an abnormal T2 signal in the deep and subcortical white matter visualized on MRI associated with hypertension, cerebrovascular disease, and aging. The Fazekas (Fz) scoring system is a commonly used qualitative tool to assess the severity of WMH. While studies have compared Fazekas scores to other scoring methods, the comparison of Fazekas scores and volume of WMH using current semiautomated volumetric techniques has not been studied. We reviewed MRI studies acquired at our institution between 2015 and 2017. Relative WMH was scored by one author trained in Fazekas scoring. A board certified neuroradiologist scored them independently for confirmation. Manual segmentations of WMH were completed using 3D Slicer 4.9. A 3D model was formed to quantify WMH in milliliters (mL). ANOVA tests were performed to determine the association of Fazekas scores with corresponding WMH volumes. Among the 198 patients in our study, WMH were visualized in 163 (Fz1: n=66; Fz2: n=49; Fz3: n=48). WMH volumes significantly differed according to Fazekas score (F = 141.1, p
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2022.106333