Entorhinal cortical atrophy score
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At the time the article was created Frank Gaillard had no recorded disclosures.View Frank Gaillard's current disclosures
At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.View Rohit Sharma's current disclosures
The entorhinal cortical atrophy (ERICA) score has been developed as an alternative to the medial temporal lobe atrophy (MTA) score to help visually identify patients with Alzheimer disease by evaluating the entorhinal cortex for volume loss 1.
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An ERICA score of 2 or 3 (see below) has been shown to have higher diagnostic accuracy for distinguishing healthy controls with subjective cognitive decline from individuals with Alzheimer disease than the older medial temporal lobe atrophy (MTA) score 1.
diagnostic accuracy = 91%
sensitivity = 83%
specificity = 98%
The ERICA score should be calculated on thin coronal imaging at right angles to the long axis of the hippocampus (standard hippocampal views) and assessed at the level of the mammillary bodies 1.
The ERICA score ranges from 0 to 3, with higher values indicating a higher degree of atrophy and a higher likelihood of Alzheimer disease. In the age-matched case control studied that derived the ERICA score, a score of 2 or greater had a sensitivity of 83% and specificity of 98% for probable Alzheimer disease rather than subjective cognitive decline 1.
score = 0
normal volume of the entorhinal cortex and parahippocampal gyrus
score = 1
mild atrophy of the entorhinal cortex and parahippocampal gyrus
widening of the collateral sulcus
score = 2
moderate atrophy of the entorhinal cortex and parahippocampal gyrus
elevation of the entorhinal cortex away from the adjacent cerebellar tentorium
score = 3
marked atrophy of the entorhinal cortex and parahippocampal gyrus
wide cleft between the entorhinal cortex and the adjacent cerebellar tentorium
The presence of CSF between the entorhinal cortex and the tentorium (ERICA 2 or 3) has been termed the “tentorial cleft sign” 1.
- 1. Enkirch S, Traschütz A, Müller A et al. The ERICA Score: An MR Imaging–based Visual Scoring System for the Assessment of Entorhinal Cortex Atrophy in Alzheimer Disease. Radiology. 2018;288(1):226-333. doi:10.1148/radiol.2018171888 - Pubmed